KR102367993B1 - Articulatable members having constrained motion, and related devices and methods - Google Patents

Abstract

The articulated member includes a distal end, a proximal end, an actuating member and a constraining member. The actuation member extends from the proximal end to the distal end. The actuating member transmits a force to flex the articulated member from a neutral position. The constraining member extends from the proximal end to the distal end. The constraining member may have both ends secured to the distal end and the proximal end. In one embodiment, the constraining member follows a helical path along at least a portion of the articulated member from the proximal end to the distal end. In another embodiment, the actuating member follows a helical path along at least a portion of the articulated member.

Description

An articulating member having a constraining motion, and a device and method related thereto

FIELD OF THE INVENTION The present invention relates to an articulating member that exhibits constraining motion. More particularly, the present invention relates to surgical instruments and related systems and methods for using such articulating members.

Remotely controlled surgical instruments, which may include manually operated (eg, laparoscopic, thoracoscopic) surgical instruments in addition to teleoperated surgical instruments, are often used in minimally invasive medical procedures. During a medical procedure, a surgical instrument may be articulated to position a portion of the instrument in a desired position. Positioning of a surgical instrument in a desired location or orientation may be accomplished by constraining motion of one or more joints of the surgical instrument. However, a mechanism that constrains the motion of one or more joints of a surgical instrument increases the mechanical complexity and operability of the surgical instrument, increasing the difficulty of manufacturing the surgical instrument.

The overall size of a minimally invasive surgical instrument may result in design constraints of the surgical instrument. For a variety of applications, it is desirable that the overall size, including the external lateral dimensions (eg, diameter), of such surgical instruments be relatively small to fit within narrow lumens and other passageways. Therefore, in some cases, It is desirable to select the number and arrangement of force transmission elements to reduce the overall size of the surgical instrument, for example, to provide an actuating force to control bending of a series of articulated links. The number and arrangement of force transmission elements interconnecting the possibly connected links may be such that the one or more force transmission elements are directly attached to and passed through the one or more links without terminating therein. Bending and steering of a plurality of joints (or pairs of links) in series, without each joint or pair of links being individually and directly capable of bending by actuation of a force transmitting element directly attached to such pair of links, It can be actuated through a single force transmission element (or, in the case of multiple bending directions and/or degrees of freedom (DOF), a single set of force transmission elements. This configuration is sometimes referred to as "underconstrained"). In other words, the steering and bending of multiple link pairs is actuated by a single force transmitting element or a single set of force transmitting elements terminating attached to one link of one of the link pairs. However, this “constraint An under" configuration can pose challenges to attempts to controllably steer and flex that configuration, with the potential to result in unpredictable and/or uncontrollable motion (articulation) of the links.

Control systems and other mechanisms have been proposed to help constrain the motion of jointed link structures that are otherwise underconstrained. However, a need exists to provide an alternative design that achieves constraint motion that can precisely control the motion and positioning of the articable member.

Embodiments of the present invention may solve one or more of the above-mentioned problems and/or realize one or more of the above-mentioned desirable features. Other features and/or advantages may become apparent from the description below.

According to at least one exemplary embodiment, the articulated member includes a distal end, a proximal end, an actuation member and a constraint member. The actuation member may extend from the proximal end to the distal end. The actuating member may transmit a force to flex the articulated member from a neutral position. The restraining member may extend from the proximal end to the distal end. The constraining member may have opposite ends secured to the distal end and the proximal end, respectively. Further, the restraining member may follow a helical path along at least a portion of the articulated member from the proximal end to the distal end.

According to another exemplary embodiment, the articulated member includes a proximal end, a distal end, an actuating member and a constraining member. The actuation member may extend from the proximal end to the distal end. The actuation member may be configured to transmit a force to flex the articulation member from a neutral position. The constraining member may extend from the proximal end to the distal end. The restraining member may have opposite ends secured to the distal end and the proximal end, respectively. Further, the actuating member may follow a helical path along at least a portion of the articulated member between a proximal end and a distal end of the articulated member.

According to another exemplary embodiment, a surgical instrument comprises a shaft, a force transmission mechanism connected to the proximal end of the shaft, a parallel motion mechanism connected to the distal end of the shaft, a wrist, an actuating member and restraint. include absence. The wrist may include a plurality of links and connectable to a distal end of the parallel exercise device. The actuation member may transmit a force from the force transmission mechanism to flex the articulated member from a neutral position or to flex the wrist from a neutral position. The constraining member may extend through at least the wrist. The constraining member is capable of passively constraining at least the motion of the wrist mechanism. Both ends of the restraining member may be secured to a proximal end and a distal end of the wrist, respectively.

Still other objects, features and advantages will be set forth in part in the description that follows, in part will be apparent from the description, or may be learned by practice of the specification and/or claims. At least some of these objects and advantages may be realized and attained by means of the elements and combinations particularly pointed out in the appended claims.

Both the foregoing schematic description and the following detailed description are for purposes of illustration and description of the present invention only, and are not limitations of the present invention claimed, and the claims should be construed as the full scope of the present invention including the equivalents thereof. .

BRIEF DESCRIPTION OF THE DRAWINGS The present invention may be understood from the following detailed description, set forth alone or in conjunction with the accompanying drawings. The drawings are included for a clearer understanding of the present invention, and are incorporated in and constitute a part of this specification. The drawings illustrate one or more exemplary embodiments of the teachings of the present invention, and together with the detailed description that follows, serve to explain the principles and operation of the present invention.
1A illustrates a teleoperated surgical system according to an exemplary embodiment.
1B shows a portion of a manipulator arm of a patient-side cart according to one exemplary embodiment of the present invention.
2 is a top view of an exemplary embodiment of a surgical instrument including a force transmission instrument.
3 is a fragmentary view of a distal portion of a surgical instrument including a jointed link structure according to one exemplary embodiment;
4 is a partial top view of a shaft portion of a surgical instrument and a force transmission instrument according to one exemplary embodiment.
FIG. 5 is a partial view of FIG. 3 with the disks removed to expose internal components;
Fig. 6 is a perspective view showing a planar projection of a spiral-shaped actuating member and a spiral-shaped angular range, according to one exemplary embodiment;
7A and 7B are a side view of one exemplary embodiment of a joint-type link structure and a cross-sectional view of a disc of a joint-type link structure for explaining the helical path of a constraint tendon;
Fig. 8A is a top perspective view of a disk of a joint-type link structure according to an exemplary embodiment;
Fig. 8B is a top perspective view of a disk of a joint-type link structure according to an exemplary embodiment.
9 is a partial view of a distal portion of a surgical instrument including a jointed link structure in accordance with one exemplary embodiment.
FIG. 10 is a cross-sectional view taken along line 10-10 of FIG. 9 ;
Fig. 11 is a side view of a wrist including a braided structure according to one exemplary embodiment;
12 is an enlarged view of the region of FIG. 12 in FIG. 11 .
Fig. 13 is a view along line 13-13 of Fig. 11;
14 is a side view of a distal end of a surgical instrument including a jointed link structure having a braided structure, according to one exemplary embodiment.
Fig. 15 is a side view of a jointed link structure including a braided structure, according to an exemplary embodiment.
16 is a fragmentary perspective view of a distal portion of a surgical instrument including a parallel motion instrument in accordance with one exemplary embodiment.
FIG. 17 is a fragmentary perspective view of the distal portion of the surgical instrument of FIG. 16 with the parallel motion instrument operated in a biased configuration, according to one exemplary embodiment.
18 is a view of the distal portion of the surgical instrument of FIG. 16 with the outer surface removed to facilitate viewing of various durable components.
19 is a schematic perspective view of a center tube and actuation member extending through a parallel motion mechanism, according to one exemplary embodiment.
Fig. 20 is an end view of a disk of a parallel motion mechanism according to an exemplary embodiment.
21 is a fragmentary perspective view of a distal portion of a surgical instrument including a wrist and a parallel motion instrument with a shared restraint mechanism, according to one exemplary embodiment.

The description of this section and the accompanying drawings, which describe exemplary embodiments, should not be taken as limiting the scope of the present invention. Various mechanical, compositional, structural, electrical and operational changes may be made without departing from the scope of the claims, including the scope of the description and equivalents in this section. In some instances, well-known structures and techniques are not shown or described in detail in order not to obscure the description of the present invention. The same reference numbers in two or more drawings indicate the same or similar elements. In addition, elements and their associated detailed features described in detail in connection with one embodiment may be included in other embodiments not specifically shown or described whenever practicable. For example, if an element is described in detail with respect to one embodiment but not with respect to a second embodiment, that element may nevertheless be claimed as included in the second embodiment.

For the purposes of this specification and the appended claims, unless otherwise indicated, all numbers expressing quantities, percentages or ratios, and numerical values used in this specification and claims, are in all instances "about" unless otherwise modified. It should be understood as being modified by the term ". Accordingly, unless otherwise indicated, the numerical parameters set forth in the following specification and appended claims are approximations that may vary depending on certain characteristic values expected to be obtained by the present invention. At the very least, and not as an attempt to limit the application of the doctrine of equivalents to the scope of the claims, each numerical parameter should at least be construed in light of the number of reported significant digits and by applying rounding techniques.

As used in this specification and the appended claims, the singular forms of expressions such as "a" and "the one" and expressions indicating any single use are plural unless specifically and explicitly limited to the single object. It should be noted that it is construed as including the subject of As used herein, the terms "comprise", "comprising" and equivalent expressions are not intended to be limiting, and the enumeration of items in a list may be substituted for or in addition to the listed items. It is not intended to exclude similar items.

Also, the terminology of these descriptions is not intended to limit the present invention. For example, spatially relative terms such as "below", "below", "lower", "above", "upper", "proximal", "distal", etc. refer to another element of one element as illustrated in the figures. It may be used to describe the relationship of one feature to another or the relationship of one feature to another. These spatially relative terms are intended to encompass the position and orientation depicted in the figures, as well as other positions (ie, positions) and orientations (ie, rotational positions) of the device in use or operation. For example, if the device in the figures were turned over, an element described as “below” or “below” another element or feature would this time be “above” or “above” the other element or feature. Thus, the exemplary term “below” may encompass the position and orientation of both above and below. The device may be otherwise oriented (eg, rotated 90 degrees or at other orientations), and spatially relative terms used herein may be interpreted accordingly. The relative proximal and distal orientations of the surgical instruments are indicated in the figures.

In various instruments having an articulating member, such as a jointed link structure, motion of the articulating member is constrained by actively controlling the motion of a component (eg, a disk) of the articulating member. do. An actuating member, such as a drive tendon or drive rod, used to articulate the articulating member may also be used to actively constrain the motion of the articulating member. For example, the actuating member may be connected to a force transmitting mechanism such as a gimbal cable actuator disclosed in US Pat. No. 6,817,974, wherein a force transmitted to the actuating member through the force transmitting mechanism moves the disk and causes a joint type It can be connected to a jointed link structure so that it can be used to articulate the link structure. Such a configuration may also be used to actively constrain the motion of the disk, such as by transmitting a force from a force transmission mechanism to an actuation member to hold the disk in place.

In some cases, a mechanism that actively constrains motion through an actuation member may include a relatively large number of actuation members in order to precisely control the motion of the articulation member as it articulates or its motion is constrained. is available. For example, a wrist may include additional joints to increase the range of motion of the wrist. However, this may result in an additional actuating member for actuating and/or constraining an additional joint, thereby increasing the complexity and cost of the list, particularly when the joints are actively constrained. Moreover, especially in the case of instruments with small diameters, it is generally desirable to use a small number of actuating members to save space within the instrument. In addition to number, the nature of the active controllable constraining member (eg, the actuating member used to actively constrain motion of the articulated member using a force applied to the actuating member) is a function of the mechanism used to apply the force to the actuating member. This can increase the complexity of the list. Accordingly, it may be desirable to provide a constraining member that is not actively constrained.

Various exemplary embodiments of the present invention contemplate an articulating member in which the motion of the articulating member is passively constrained. That is, the motion of the articulated member is constrained without the use of an actuator, such as a force transmission mechanism, and a control algorithm controlling the same. For example, in various exemplary embodiments, the motion of the disc of the articulated link structure is not actuated by an external actuator or transmission mechanism, but rather is at a restraining member responsive to the motion (articulation) of the articulated link structure itself. passively constrained by According to one exemplary embodiment, the restraining member may be fixed to both ends of the joint-type link structure. As a result, the constraining member does not need to use a force transmission mechanism that actively constrains the motion of the articulating member, which allows the use of fewer actuating members and potentially less complex force transmission mechanisms. Also, both ends of the constraining member may be fixed to both ends of the articulated member. Thus, the constraining member does not need to extend to the proximal end of the instrument where an actuator, such as a force transmission mechanism, is disposed, thereby saving space along the instrument shaft on the proximal side of the articulated member. Also, by not extending the constraining member through the lumen (eg, shaft) of the instrument to the proximal end of the instrument, the interior space of the lumen may be easier to clean because fewer entities are present within the lumen.

According to various exemplary embodiments, the present invention contemplates an articulating member for a surgical instrument comprising a mechanism for constraining motion of the articulating member. The restraint mechanism may be secured to both ends of the articulating member, which may be a wrist, parallel motion mechanism, or other articulating member used in a surgical instrument. In various exemplary embodiments, the articulated member is a jointed link structure. In one embodiment of the list of instruments, the restraining mechanism extends along a helical path along at least a portion of the length of the wrist. The wrist may also include an actuating member, such as a drive tendon, extending substantially straight through the wrist. The list may include a series of connected disks that pivot about axes of rotation that are staggered in different directions (eg, orthogonal), or that pivot about at least two consecutive axes of rotation extending in substantially the same direction. The restraint mechanism is not limited to a tendon or rod, but may instead be a braided structure that may be used to provide the structure of the articulated member, for example by replacing the disc of the articulated link structure, or the like. Optionally, the braided structure may be used to constrain the motion of the disc of the articulated link structure. In a parallel motion mechanism, the restraining mechanism may extend substantially linearly through the parallel motion mechanism, while the drive tendon for the parallel motion mechanism extends along a helical path when extending through at least a portion of the length of the parallel motion mechanism. According to one exemplary embodiment, when the surgical instrument comprises both a wrist and a parallel motion instrument, the restraint mechanism may be used to constrain the motion of at least the wrist or both the wrist and parallel motion instrument. In another example, separate restraint mechanisms may be used to restrain movement of the wrist and parallel movement mechanism.

Referring now to FIG. 1A , as one exemplary embodiment of a teleoperated surgical system 100 , a patient-side cart 110 , a surgeon's console receiving input from a user to control instruments of the patient-side cart 110 , One exemplary embodiment of a teleoperated surgical system 100 is shown that includes 120 and an auxiliary control/vision cart 130 . System 100 is, for example, a da Vinci® Surgical System, da Vinci® Si (model no. IS3000), Single Site da Vinci® Surgery available from Intuitive Surgical, Inc. system or the da Vinci® Xi surgical system. However, various other teleoperated surgical system types may be used with the exemplary embodiments described herein. Referring now to the schematic diagram of FIG. 1B , there is shown a portion of an exemplary embodiment of a manipulator arm 140 of a patient-side cart having two surgical instruments 141 , 142 in an installed position. Although the schematic of FIG. 1B shows only two surgical instruments for simplicity, three or more surgical instruments may be accommodated in the installation position of the patient-side cart, as will be appreciated by those skilled in the art. Each surgical instrument 141 , 142 includes an instrument shaft 150 , 151 having at its distal end a movable end effector (described below with respect to FIG. 2 ) or a camera or other sensing device, the distal end It may or may not include a wrist mechanism (described below with respect to FIG. 2 ) for controlling movement.

In the exemplary embodiment of FIG. 1B , distal end portions of surgical instruments 141 , 142 are received via single port structure 152 for introduction into a patient. Other types of patient side carts that may be used with the present invention may use multiple individual manipulator arms. In addition, individual manipulator arms may include a single instrument or multiple instruments. Additionally, the instrument may be a surgical instrument having an end effector, or providing information (eg, visualization, electrophysiological activity, pressure, fluid flow, and/or other sensing information) of a camera instrument or remote surgical site used during a surgical procedure. There may be other sensing devices used to

A force transmission mechanism 147 , 148 is disposed at the proximal end of the respective shaft 150 , 151 and is coupled with the actuation interface assembly 143 , 144 via a sterile adapter 145 , 146 . The actuation interface assembly 143 , 144 is configured to respond to a controller (eg, surgical and various mechanisms (described in greater detail below with respect to the exemplary embodiment of FIG. 2 ) controlled by the system's control cart (located on the control cart).

The diameters of the instrument shaft, wrist and end effector are generally selected according to the size of the cannula to be used with the instrument and also according to the surgical procedure being performed. In various exemplary embodiments, shafts and/or wrists, for example, about 3 mm, 4 mm, 5 mm, 6 mm, 7 mm or 8 mm diameter, are inserted into some existing cannula systems, although larger instrument sizes are also within the scope of the present invention. is considered to be According to one exemplary embodiment, depending on the type of surgical instrument, one or more surgical instruments 141 , 142 may communicate with the flux source 160 via a flux transmission conduit 132 . For example, when surgical instrument 141 is an electrosurgical instrument, flux transmission conduit 132 is an electrical energy transmission cable, and flux source 160 is an electrical energy generator.

Referring to FIG. 2 , there is shown a schematic bottom view of a surgical instrument 240 according to one exemplary embodiment. The surgical instrument 240 includes a force transmission instrument 250 , a shaft 260 connected to the force transmission instrument 250 at a proximal end 263 of the shaft 260 , and an end connected to the distal end 265 of the shaft 260 . It may include an effector 280 . According to one exemplary embodiment, the end effector 280 may be coupled to the distal end 265 of the shaft 260 via a wrist 270 as shown in FIG. 2 . The wrist 270 may be operated in one or more degrees of freedom (DOF) (eg, pitch, yaw, roll) to position the end effector 280 in a desired position.

Instrument 240 may include another joint, such as a parallel motion instrument (not shown), positioned between wrist 270 and distal end 265 of shaft 260 according to one exemplary embodiment. For exemplary parallel exercise machines and their functions, see US Pat. No. 7,942,868, issued May 17, 2011, and published US Patent Application, US 2008/0065105, issued Mar. 13, 2008, the entire disclosures of which are incorporated herein by reference. do.

Surgical instrument 240 is one for transmitting force between force transmitting instrument 250 and end effector 280 and between force transmitting instrument 250 and wrist 270 and/or parallel motion instrument (not shown). It may include more than one operation member. For example, one or more actuation members 290 may couple force transmission mechanism 250 to end effector 280 to provide actuation force to end effector 280 . The actuating member may extend along the interior of the shaft 260 . By using the actuating member 290, the force transmission mechanism 250 may actuate the end effector 28 and/or the mechanism, for example, to control the yaw of the end effector 280 (or other movable portion). 240) of the list 270 can be controlled. The actuating member 290 may be, for example, a tension member such as a cable, wire, or the like, and may actuate the surgical instrument in a pull-pull manner. In another exemplary embodiment, the actuating member 290 is a compression member, such as a push rod, for example, a push rod as disclosed in US Pat. No. 8,545,515, issued Oct. 1, 2013, the entire disclosure of which is incorporated herein by reference. - Can work in a push-pull manner.

The force transmission instrument 250 may include one or more components that engage the patient side cart of the teleoperated surgical system to transmit forces provided by the patient side cart to the surgical instrument 240 . According to one exemplary embodiment, the force transmission mechanism 250 includes one or more actuator disks 252, 254 that engage a patient-side manipulator of a patient-side cart as disclosed in US Pat. No. 8,545,515. Accordingly, the actuator disks 252 and 254 may provide different DOFs of the instrument 240 including, but not limited to, roll, pitch, yaw, and/or various end effector motions (eg, open, close, translate), for example. Uses force from a remote-controlled (robot) manipulator to actuate the The force transmission mechanism 250 is not limited to the two actuator disks 252 , 254 , but may include fewer or more actuator disks. For example, force transmission mechanism 250 may include a number of actuator disks corresponding to the number of DOFs of mechanism 240 , and some disks or combinations of disks may control multiple instrument DOFs. Also, the driver disks 252, 254 are shown as being substantially parallel to the plane of the page of FIG. 2, such that the axis of rotation of the driver disks 252, 254 extending substantially perpendicular to the plane of the page of FIG. While generating (not shown) the shaft 260 is substantially parallel to the plane of the page of FIG. 4 , the embodiments described herein may, for example, rotate the actuator disks extending substantially parallel to the shaft 260 . It would also be possible to use a force transmission mechanism comprising actuator disks configured in other configurations, such as those with an axis.

The diameters of the shaft 260 , wrist 270 and end effector 280 of surgical instrument 240 are selected according to the diameter of the camera instrument, as well as the size of the cannula with which the instrument will generally be used. In another exemplary embodiment, the diameter of the camera mechanism and the diameter of the wrist 270 and main shaft 260 may range from about 3 mm to about 10 mm. In another exemplary embodiment, the diameter of the camera mechanism and the diameter of the wrist 270 and main shaft 260 may be in the range of about 5 mm to about 8 mm. For example, the diameter may be, for example, about 4 mm, about 5 mm, about 6 mm, about 7 mm, or about 8 mm to be sized to be inserted into some existing cannula system. Also, although instruments may have a circular cross-section, instruments having a non-circular cross-section are also contemplated. For example, it may have an elliptical cross-section, such as a cross-section having a major axis having a length of, for example, from about 13 mm to about 17 mm and a minor axis having a length, for example, from about 8 mm to about 10 mm.

Systems and techniques for constraining motion (bending) of an articable member, such as a wrist, can enable precise control of an articulating member by minimizing unwanted motion of the components of the articulating member. For example, the restraint mechanism may cause slipping or misalignment of the disk relative to another disk in the jointed link structure, or motion of the disk in an unintended direction that may result in an S-shape when an arc shape with a single bend is desired. can be minimized.

As noted above, motion of an articulated member, such as a wrist, may be actively constrained by coupling a set of actuating elements (eg, tendons) to one or more force transmission mechanisms, such as force transmission mechanism 250 . . The various instruments within the delivery mechanism of the instrument may be used to provide control over the actuating elements, thereby functioning to constrain motion of the articulated link structure or other articulated member.

The constraint configuration using multiple sets of cables that terminate at each of a series of disks to actively control the motion of the disks and extend to a force transmission mechanism located at the proximal end of the instrument increases the mechanical complexity of the instrument and requires the use of other components. It can take up valuable space in a small appliance that can be used for

In view of these considerations, various exemplary embodiments of the present invention can be performed in a relatively repeatable, precise, and smooth manner in which articulation of the articulating member is positioned to position the articulating member in a desired and predictable shape. An articulating member is intended that exhibits a constraining motion to be achieved. In addition, an instrument comprising an articulating member according to an exemplary embodiment of the present invention may have a mechanically less complex force transmission mechanism, and may be relatively easy to operate, despite the relatively small overall diameter of the instrument; It can be cost effective to manufacture.

According to one exemplary embodiment, the articulating member having constraining motion is a jointed link structure used as a wrist in a surgical instrument. Referring to FIG. 3 , a distal portion 300 of the instrument shaft is shown. As a non-limiting example, the surgical instrument may be a camera instrument or a surgical instrument having an end effector supported by a wrist according to the exemplary embodiment of FIG. 2 . For example, an end effector or camera device (not shown) may be collar connected to the distal end 302 of the surgical instrument distal portion 300 , which may be, for example, a collar. As shown in FIG. 3 , the distal portion 300 may include a wrist 310 coupled to a portion 316 of the instrument proximal to the wrist 310 . Portion 316 may be, for example, the distal end of an instrument shaft according to the exemplary embodiment of FIG. 2 , and may be the distal end of a parallel motion instrument as described below. The wrist 310 is a jointed link structure comprising a plurality of disks connected at joints between the disks to provide motion to the wrist 310 in any pitch and/or yaw direction. For example, list 310 shows disks 311-315, although other numbers of disks may be used in the list, such as 7 disks (as in a risk mechanism with six joints) or a higher number of disks. ) may be included. While the example embodiments described herein are described as including disks, this is just one possible non-limiting configuration. For example, links may be used in place of the disks of the exemplary embodiments described herein. According to one exemplary embodiment, the disks 311-315 may include mechanical stops (not shown) to limit motion of the wrist 310, such as in pitch and/or yaw direction.

3 , wrist 310 also includes a joint 322 providing an axis of rotation 350 between the pair of disks 311 , 312 ; a joint 324 providing an axis of rotation 352 between the pair of disks 312 , 313 ; a joint 326 providing an axis of rotation 354 between the pair of disks 313 , 314 ; and a joint 328 providing an axis of rotation 356 between the pair of disks 314 , 315 . Axes 350 and 354 extend in substantially the same direction as each other, and axes 352 and 356 extend in substantially the same direction as each other and substantially orthogonal to axes 350 and 354 . Accordingly, as shown in FIG. 3 , axes 350 , 352 , 354 , 356 are arranged to provide arbitrary pitch and yaw motion of joints 322 , 324 , 326 328 , and axes 350 , 352 , 354, 356) are staggered in different directions. Joints 322 , 324 , 326 , 328 each have a single axis in the exemplary embodiment of FIG. 3 (axes 350 , 352 , 354 , 356 for each joint 322 , 324 , 326 , 328 respectively). Although shown as having a , joints 322 , 324 , 326 , 328 may instead include other numbers of axes. For example, joints 322 , 324 , 326 , 328 are examples of US Pat. No. 8,911,428, issued Dec. 16, 2014, the entire disclosure of which is incorporated herein by reference, including the embodiment of FIG. 25 of US Pat. No. 8,911,428. According to the embodiment of the joint movement can be.

As shown in the exemplary embodiment of FIG. 3 , one or more actuating elements 320 extend through the wrist 310 . The actuating element 320 may actuate the wrist 310 , such as by securing the distal end of the actuating element 320 to the instrument shaft portion 300 to the distal end 302 or to the disk 311 of the wrist 310 , etc. It may be a tendon used to make the In another example, the one or more actuating elements 320 actuate other components of the instrument, such as an end effector of a surgical instrument, such as along the actuating member 290 and end effector 280 of the exemplary embodiment of FIG. 2 . can be used to make The actuating element 320 may extend substantially straight as the actuating element 320 through the wrist 310 as shown in FIG. 3 according to one preferred embodiment.

According to one exemplary embodiment, the actuating elements 320 may be arranged in pairs extending through the wrist 310 , the shaft of the instrument, to the force transmitting instrument. Force transmission mechanisms may include various types of mechanisms for actuating actuating elements, such as, for example, capstans, gears, levers, gimbals, rack and pinion devices, pulleys, and other devices familiar to those skilled in the art. For example, four actuating elements 320 arranged in two pairs may extend through wrist 310 , although other numbers of actuating elements 320 and pairs of actuating elements 320 may be used. A pair of actuating elements 320 actuates actuating elements 320, such as in the form of a pull-pull drive mechanism or a push-pull drive mechanism as described in US Pat. No. 8,545,515. It can be connected to the capstan to allow The capstan is an interface disk 252 of the force transmission mechanism 250 of the exemplary embodiment of FIG. 2 that transmits a force received from a patient-side manipulator of the patient-side cart 110 of the exemplary embodiment of FIG. 1A according to one illustrative embodiment. , 254 , causing the capstan to rotate and actuate the actuating element 320 . Other force transmission mechanisms familiar to those skilled in the art may also be used, and the capstan is a non-limiting, exemplary configuration.

As shown in the exemplary embodiment of FIG. 4 , when the actuating element 364 is a pull-pull actuating element, etc., the actuating element 364 extends through the shaft 362 of the instrument to the force transmission mechanism 360 . can be In another exemplary embodiment, the actuating element 364 may be a push-pull actuating member and the capstan 366 may be replaced with a gear that drives the actuating element 364 . The force transmission mechanism 360 may be configured according to the exemplary embodiment of FIG. 2 . For example, the force transmission mechanism 360 may include an interface actuator disk that actuates the capstan 366, similar to the interface actuator disks 182 , 184 of the exemplary embodiment of FIG. 2 .

List 310 may include a structure that passively constrains movement of wrist 310 . According to one exemplary embodiment, wrist 310 may include one or more constraint tendons extending through wrist 310 . To constrain movement of wrist 310 , restraint tendons may be secured to the distal and proximal ends of wrist 310 . According to one exemplary embodiment, a passive restraining tendon may be secured to the end of the articulating portion of the wrist and the articulated portion provided by, for example, disks 311-315. Thus, as will be described below, the passive restraining tendons may be secured, for example, to the disks 311 and 315 themselves or at a location proximate to the disks 311 and 315 . When the wrist 310 is articulated to flex in the desired direction, the restraining tendon will flex with the wrist 310 . Because the restraining tendons are secured to the distal and proximal ends of the wrist 310 , the restraining tendons have a fixed length with respect to the wrist 310 , causing the restraining tendons to passively apply a force to the discs 311-315 . Thus, when one of the disks 311-315 begins to translate radially relative to the other, the restraining tendons act on the translating disk, resisting that translation and causing the disk to move along the longitudinal axis of the wrist. Trying to keep it sorted accordingly. For example, when disk 313 is subjected to a force that acts to translate the disk 313 relative to disks 312 and 314 along direction 358, it passes through holes in disk 313. Restraining tendons in contact with disk 313 by doing or the like will act on disk 313 to resist radial translation along direction 358 , thereby attempting to constrain translation of disk 313 .

The restraining tendons may be secured in place, for example through welding the restraining tendons in place, crimping the restraining tendons to another object, or by other methods familiar to those skilled in the art. For example, the distal end of the restraining tendon may be secured to the disk 311 or to the distal end 302 of the instrument, and the proximal end of the restraining tendon may be secured to the disk 315 or proximal to the wrist 310 . may be secured to instrument portion 316 . Referring to FIG. 5 , which shows the distal instrument shaft portion 300 of FIG. 3 , but in which the disks 312 - 314 are indicated by dashed lines to expose the internal components of the wrist 310 , one preferred embodiment Accordingly, restraining tendons 330 , 332 , 334 , and 336 are each secured to the proximal end of wrist 310 by crimps 338 . The crimp 338 may be disposed within the passageways of the disk 315 or instrument portion 316 . The distal ends of the restraining tendons 330 , 332 , 334 , 336 may also be secured within the passageways of the disk 311 or instrument shaft distal portion 300 by crimps (not shown).

According to one exemplary embodiment, the restraining tendons may be secured in place to apply a tensile force to the restraining tendons. The tensile force (also referred to as pre-loaded tension) applied to the fixed restraining tendon when the wrist is in a substantially straight or neutral configuration as shown in the exemplary embodiment of FIG. may range from, for example, approximately 0 pounds to 5 pounds. When the tensile force is, for example, approximately zero pounds in a substantially straight or neutral configuration, the restraining tendon may apply a force to the discs of the wrist to constrain the motion of the discs as soon as the wrist is articulated. According to another exemplary embodiment, the tensile force applied to the fixed restraining tendon when the wrist is in a substantially straight or neutral configuration as shown in the exemplary embodiment of FIG. 3 ranges, for example, from approximately 3 pounds to approximately 5 pounds. can tomorrow Because the restraining tendons are secured to both ends of the wrist according to one exemplary embodiment, the restraining tendons do not extend through the shaft of the instrument to the force transfer mechanism and are not actuated by the force transfer mechanism, which It can simplify the operation, facilitate the control, and save the instrument space.

According to one exemplary embodiment, the restraining tendons may be twisted through at least a portion of the wrist (eg, in a substantially helical pattern). Although list 310 includes four restraining tendons 330, 332, 334, 336 as shown in the exemplary embodiment of FIG. 5, the present invention provides two, three, five, six, Other numbers of constraining tendons are also contemplated, such as 7, 8 or more constraining tendons. According to one exemplary embodiment, restraining tendons 330 , 332 , 334 , 336 extend along a helical path from disk 311 to disk 315 as shown in FIG. 5 , such that restraining tendons 330 are , 332, 334, 336) traverse the helix path.

According to one exemplary embodiment, the restraining tendons of the exemplary embodiments described herein may continuously curve to follow a substantially twisted path as they extend along the helical paths. For example, the restraining tendons may extend along a helical path having a substantially constant radius of curvature or having different radii of curvature at various sections along the restraining tendons. According to another exemplary embodiment, restraining tendons extending along a helical path may include one or more straight path segments extending substantially linearly. For example, the restraining tendons may include straight sections extending between the disks, such as between each of the disks 311-315, for example. The restraining tendons may extend along a helical path by including a series of substantially straight sections angled with respect to each other to provide a helical path, according to one exemplary embodiment. According to another exemplary embodiment, the restraining tendons may include a mixture of one or more curved sections that are curved and one or more substantially straight sections. For example, the restraining tendons may be curved as they pass through the disks and be substantially straight between the disks. According to one exemplary embodiment, the inclination of the restraining tendons as they extend along the longitudinal direction of the instrument may be substantially constant or may vary. For example, the slope of the restraining tendons may vary from one curved section to another curved section, from one straight section to another straight section, or a straight section of the constraining tendon as the constraining tendon extends along the longitudinal direction of the device. and can vary between curved sections. Irrespective of whether the helical paths followed by the constraining tendons include some straight section or varying degree of curvature, the helical path can be considered approximately helical such that the constraining tendons extend over a range of angles when projected onto a plane.

The angular range of the helical path of one constraining tendon is shown in the exemplary embodiment of FIG. 6 . As shown in FIG. 6 , the helically twisted tendon extends from a first end 402 to a second end 406 in a helical path ( 400) is extended. To show the angular extent of the spiral path 400 , the spiral path 400 may be projected onto a plane 401 perpendicular to the axis 408 . The projection is an arc 410 in which the twisted helix path 400 has a radius of curvature 403 that corresponds to the radius of curvature, and the points on the arc 410 correspond to positions on the helix path 400 . For example, point 412 on arc 410 corresponds to first end 402 of the helix path, and point 414 on arc 410 is approximately at midpoint 404 along the length of the helix path. corresponds to Although the helical path 400 is shown in the exemplary embodiment of FIG. 6 as having a substantially continuous radius of curvature 403 , the helical path 400 (and thus the arc 410 ) is different as described above. Sections having curvature may be included, and one or more straight sections may be included. Thus, when a helical path is described in preferred embodiments, the helical path may have a helical shape with a substantially continuous radius of curvature, or the helical path may have curved sections and/or straight sections with different radii of curvature. It may include sections having different radii of curvature, including .

As shown in FIG. 6 , the angular range 420 between points 412 and 414 on arc 410 about centerline 408 (also projected onto plane 401 ). is approximately 180°. Thus, when the angular range of the helical path is described in the exemplary embodiments herein, the angular range is to be determined according to the angular range 420 with respect to the centerline 408 as shown in FIG. Also, since the helical path 400 completes a full 360 degree helical twist from the first end 402 to the second end 406 , the point 412 on the arc 410 is at the first end 402 ) and the second end 406, the angular range 422 between the first end 402 and the second end 406 becomes 360 degrees. Arc 410 forms a perfect circle, but in embodiments where the helical path does not complete a full 360 degree twist, since the angular range of the helical path is less than 360 degrees, arc 410 completes the circle. won't

According to one exemplary embodiment, the restraining tendons 330 , 332 , 334 , 336 have an angular range of approximately 360 degrees along the entire length of the wrist 310 such that the restraining tendons 330 , 332 , 334 , 336 have an angular range. so as to extend along a spiral path. For example, restraint tendons 330 , 332 , 334 , 336 may be located between each disk 311-315 of wrist 310 when wrist 310 contains four disks 311-315 . may extend along a helical path having an angular range of approximately 90 degrees. That is, the constraining tendons 330 , 332 , 334 , and 336 are between each disk 315 and disk 314 , between each disk 314 and disk 313 , and between each disk 313 and disk 312 . ) and between each disk 312 and disk 311 may extend along a helical path having an angular range of approximately 90 degrees. In another exemplary embodiment, the list is such that the constraining tendons of the list extend along a twisted path having an angular range of approximately 60 degrees between each disk of the list, and the entire angular range along the entire list is constrained. With 360 degrees to the tendons, it can contain 6 discs. Thus, the constraining tendons are twisted having an angular range equal to the total angular range (eg, 360 degrees) across the list for the constraining tendons, divided by the number of disks in the list, according to one exemplary embodiment. It can be extended along the true path. However, various exemplary embodiments of the present invention contemplate that the constraining tendons of the wrist may extend to other angular ranges along the helical path. For example, the restraining tendons may extend along a helical path such that the magnitude of the angular range is different between the different disks of the wrist. Such an arrangement can provide a list that achieves different degrees of flexion (articulation) along different segments along the length of the list. Also, the total angular range of the restraining tendons may be an integer multiple of 360 degrees, such as when the instrument contains a list of integer multiples, according to one exemplary embodiment. Further, the restraining tendons may extend along a helical path having a size other than approximately 90 degrees between the disks, such as approximately 180 degrees, for example, according to one exemplary embodiment. According to one exemplary embodiment, restraint tendons are exemplary embodiments of US Provisional Patent Application Serial No. 61/943,084, filed Feb. 21, 2014 (Attorney Docket No. ISRG04490PROV/US), the entire disclosure of which is hereby incorporated by reference. may extend along a helical path to the size described in

To illustrate the helical path of one restraining tendon, a side view of a wrist 360 comprising disks 361-365 is shown in the exemplary embodiment of FIG. 7A , which includes the exemplary embodiment of FIG. 3 . Although other numbers of constraining tendons may be contemplated as described in connection with the embodiments, the helical path 366 of a single constraining tendon through disks 361-365 is corrugated to facilitate observation of the helical path. is shown. In addition, each section 371-375 through disks 361-365 shown in FIG. 7B describes the location of the path 366 of the restraining tendons through disks 361-365. In the exemplary embodiment of FIG. 7A , the path 366 of the constraining tendon follows a helical path having an angular range of approximately 90 degrees from disk to disk, although other angular ranges may be used as described above.

Twisting the restraining tendon to traverse a helical path through at least a portion of the wrist provides advantages other than constraining the movement of the wrist to provide precise control of the movement and shape of the wrist. For example, the restraining tendons may extend along a helical path such that the restraining tendons are positioned at locations other than joints between the discs of the wrist. As shown in the exemplary embodiment of FIG. 3 , wrist 310 prevents disks 311 and 312 from rotating (ie, pivoting) relative to each other in direction 351 about axis 350 . and a joint 322 between the disks 311 and 312 that makes this possible. Restraining tendons 334 and 336 extend between disks 311 and 312 such that the tendons 334 and 336 do not physically pass through joint 322 . That is, as shown in FIG. 3 , the restraining tendons 334 and 336 are offset from the joint 322 . As a result, joint 322 does not require hollow passageways for restraint tendons 334 and 336 , allowing joint 322 to be sized smaller while at the same time compressive load between disks 311 and 312 . It also serves to support

The restraining tendons may follow twisted paths to avoid joints connecting the disks, such that the restraining tendons are offset from the joints, which would otherwise be adjacent to the joints. For example, restraint tendons 334 and 336 are wrists where apertures 340 are provided between disks 311 and 312 (when wrist 310 is in the straight or neutral configuration shown in FIG. 3 ). It may extend between the discs 311 and 312 on the open side of 310 such that the restraining tendons 334 and 336 do not pass through the joint 322 or else the restraining tendons 334 and 336 through the joint 322. The passage of 336 will result in weakening of joint 322 . According to one exemplary embodiment, the joint 322 includes a surface 304 of the disk 311 and a surface of the disk 312 that contact each other to form a rotational joint between the disk 311 and the disk 312 ( 306) may be included. Restraining tendons 334 and 336 may extend between disks 311 and 312 such that such restraining tendons 334 and 336 do not pass through surfaces 304 and 306, which would otherwise be the case of surfaces 304 and 306. It will weaken surfaces 304 and 306 by requiring passage. For example, restraining tendons 334 and 336 may be offset from surfaces 304 and 306 of joint 322 in the transverse direction.

Likewise, restraining tendons 330 and 334 engage joint 324 that enables disks 313 and 312 to rotate relative to each other in direction 353 about axis 352 , restraining tendons 330 and 334 . ) may extend between the disks 313 and 312; Restraining tendons 330 and 332 engage joint 326 that enables disks 314 and 313 to rotate relative to each other in direction 355 about axis 354 . may extend between disks 314 and 313, so as not to physically pass through; Restraining tendons 332 and 336 engage joint 328 that enables disks 314 and 315 to rotate relative to each other in direction 357 about axis 356. It may extend between disks 314 and 315 so as not to physically pass through.

The discs in the list may be configured to position and/or guide the constraining tendons as they pass through the discs. For example, it may be desirable to avoid constraining tendons passing through joints between disks. Referring to FIG. 8A , one exemplary perspective view of a disk 500 is shown. The disks 311-315 of the list in FIGS. 3 and 5 may be configured according to the disk 500 . Disc 500 includes one or more drive tendon apertures 510 through which drive tendons may pass. For example, when the disks 311-315 of the exemplary embodiment of FIGS. 3 and 5 are configured according to the exemplary embodiment of disk 500 , the actuating element 320 extends through the drive tendon aperture 510 . can be Disc 500 may also include one or more restraining tendon apertures 512 through which restraining tendons may pass. Accordingly, when the disks 311-315 of the wrist 310 are configured according to the exemplary embodiment of the disk 500 , the restraining tendons 330 , 332 , 334 , 336 extend through the restraining tendon aperture 512 . can be Disc 500 may also include a central aperture 516 through which one or more flux conduits (eg, conductors or optical fibers) or other actuating elements for an end effector or the like may extend.

Because the restraining tendons extend in a helical path along at least a portion of the wrist, the restraining tendons have a greater circumferential extent than drive tendons that extend substantially linearly between the discs of the wrist when the wrist is actuated to articulate and flex. may sweep (eg, move in direction 530 relative to disk 500 ) across The constraining tendon aperture 512 may be disposed proximate the outer periphery 502 of the disk 500 because less sweeping of the constraining tendons may occur when they are positioned further away from the central aperture 516 of the disk. there is. Although slight sweeping of the restraining tendons may still occur, placing the restraining tendon hole 512 closer to the perimeter 502 also causes the central hole 516 and/or joint structure 520 of the disk 500 to provides more space for As shown in the exemplary embodiment of FIG. 8A , both the driving tendon hole 510 and the restraining tendon hole 512 are proximal to the outer periphery 502 of the disk 500 along a radial direction 515 of the central hole ( 516) can be placed in a similar position.

According to another exemplary embodiment, the drive tendon aperture 510 and the constraining tendon aperture 512 may be disposed at different locations along the radial direction 515 . For example, the constraining tendon aperture 512 may be positioned such that the tendon aperture 512 is disposed closer to the central aperture 516 than the drive tendon aperture 510 along the radial direction 515 . ) can be radially offset from As a result, the restraining tendons extending through the restraining tendon aperture 512 may be disposed radially inside the joint structure 520 of the disk 500 such that the restraining tendons do not interfere with the joint structure 520 . In another example, the constraining tendon apertures 512 for constraining tendons extending along different helical path directions may be offset from each other. For example, a hole for the restraining tendon 330 extending along a helical path (eg, in a left-handed direction in a proximal-distal direction) in a first direction 342 of FIG. 5 and a second direction The apertures for constraining tendons 334 extending along a helical path of 344 (eg, in a right-handed direction in a proximal-distal direction) are offset, such that the gap between the constraining tendons extending in different directions is offset. Friction can be minimized or avoided.

According to one exemplary embodiment, the drive tendon aperture 510 may be disposed at a distance from the central aperture 516 along the radial direction 515 of, for example, between about 0.095 inches and about 0.100 inches, wherein the constraining tendon apertures include: It may be disposed at a distance of, for example, from about 0.080 inches to about 0.085 inches from the central aperture 516 along the radial direction 515 . In one exemplary embodiment in which the constraining tendon apertures 512 are radially offset from the drive tendon apertures 510, the disc 500 may include four restraining tendon apertures 512 for a corresponding number of restraining tendons as shown in the exemplary embodiment of FIG. 8A . For example, 3, 5, 6, 7, 8 or more constraining tendon apertures 512 and constraining tendons may be used. According to one exemplary embodiment, the number of constraining tendons and constraining tendon apertures 512 used may be equal to, for example, the number of joints in the list containing disk 500 plus one.

To accommodate sweeping of the constraining tendons, the constraining tendon aperture 512 may have a different shape than the driving tendon aperture 510 , for example. For example, drive tendon aperture 510 may have a substantially circular cross-section, while restraining tendon aperture 512 may have an elongated, non-circular cross-section as elongated along direction 530 . For example, the constraining tendon aperture 512 may have an oval, oval, or kidney shape. In another example, the constraining tendon aperture 512 may span along direction 530 to a different extent than the driving tendon aperture 510 . For example, the constraining tendon aperture 512 may span to a greater extent than the driving tendon aperture 510 . According to one exemplary embodiment, the drive tendon aperture 510 may have a diameter in the range of, for example, about 0.020 inches to about 0.025 inches, and the constraining tendon aperture 512 along the circumferential direction 530, for example about 0.020 inches. It may have a length of between inches and 0.025 inches, and the constraining tendon aperture 512 may be greater in length or diameter than or equal to the drive tendon aperture 510 . Because of the elongate shape and/or circumferential length of the restraining tendon hole 512 , the restraining tendon hole 512 causes the restraint tendons extending through the restraining tendon hole 512 when the wrist is actuated to flex from its neutral position. Sweeping can be better accommodated.

According to one exemplary embodiment, the disk 500 may include a concave surface portion 514 disposed adjacent to and extending from the restraining tendon hole 512 . Because the restraining tendons extend along a helical path along at least a portion of the wrist, the restraining tendons can sweep against the circumferential edge 513 of the restraining tendon aperture 512 along the circumferential direction 530 . By providing a concave surface portion 514 adjacent the restraining tendon aperture 512 , the restraining tendon enters the concave surface portion 514 as the restraining tendon abuts and sweeps the distal edge 513 of the restraining tendon hole 512 . By allowing entry, more sweeping of the restraining tendon can be accommodated. The concave surface portion 514 may have an elongated shape, such as having a substantially constant depth or a depth that varies, for example, by decreasing the concave surface portion 514 away from an adjacent restraining tendon hole. The latter case thus provides a ramp-like profile from the hole 512 to the surface of the disk 500 . According to one exemplary embodiment, the concave surface portion 514 may be inclined at an angle within a range of, for example, about 20 degrees to about 30 degrees.

According to one exemplary embodiment, the disk 500 may include a joint structure 520 that forms joints between adjacent disks. The joint structure 520 may be configured in various ways. For example, joint structure 520 may include a cycloidal shape as disclosed in US Patent No. 8,887,595, issued Nov. 18, 2014, the entire disclosure of which is hereby incorporated by reference in its entirety. may be constructed according to the exemplary embodiment of US Patent No. 8,911,428, issued December 16, 2014, referenced in The joints 322 , 324 , 326 , and 328 of the exemplary embodiment of FIG. 3 may be configured like the joint structure 520 . According to one exemplary embodiment, joint structure 520 may include protrusions 522 (or teeth). The protrusion 522 has a shape corresponding to the protrusion 522 of the disk 500 and may include a recess 552 configured to receive the protrusion 522. The disk shown in the exemplary embodiment of FIG. 8B ( 540) may be inserted into a corresponding recess of an adjacent disk. According to one exemplary embodiment, the recesses 552 may form one or more pins for engaging the teeth 522 . Thus, within a pair of adjacent disks, a first disk may include one or more projections (or teeth) and a second disk may include one or more depressions (or pins) configured to receive the projections. .

According to one exemplary embodiment, the joint structure 520 of the disk 500 of the exemplary embodiment of FIG. 8A may also correspond to a corresponding protrusion 554 of the disk 540 of the exemplary embodiment of FIG. 8B , such as an adjacent disk. and a protrusion 524 configured to contact the protrusion. As a result, the protrusions 524 can function as a compressive load bearing surface between adjacent disks. Because the restraining cables are oriented away from the joint structure 520 including the load-bearing protrusions 524 and are oriented distally of the joint structure 520 , the joint structure 520 may not extend through the joint structure 520 . Not weakened by restraining cable holes. Thus, the joint structure 520 including the load-bearing protrusion 524 can be made larger, which increases the load that can be accommodated by a wrist comprising disks, such as disk 500, making the wrist larger. make it strong

Another advantage provided by extending the restraining tendons along a helical path is the substantial preservation of the length of the restraining tendons when the wrist is actuated to articulate (eg, flex). When the disks 313 and 314 are actuated to pivot relative to each other in the direction 355 about the axis 354 of FIG. 3 , the restraining tendons 330 and 332 are the length between the disks 313 and 314 . can change For example, restraining tendons 330 and 332 may be such that disks 313 and 314 are axial in a direction away from one side of wrist 310 on which restraining tendons 330 and 332 are positioned between disks 313 and 314 . When rotated relative to each other about 354 , it may undergo a positive change in length between disks 313 and 314 . Conversely, restraining tendons 330 and 332 are such that disks 313 and 314 have axis 354 in a direction towards one side of wrist 310 where restraining tendons 330 and 332 are located between disks 313 and 314. ), may undergo a negative change in length between disks 313 and 314 when rotated relative to each other. Other constraining tendons experience similar positive or negative changes in length between different disks when wrist 310 is actuated. A change in the length of the restraining tendons may affect the ability of the restraining tendons to constrain the motion of the wrist 310, such as by introducing slack to the restraining tendons.

The twist path of the constraining tendon through an articulate member, such as a wrist, may be selected to account for changes in the length of the constraining tendons. According to one exemplary embodiment, passive constraint tendons may extend along a helical path along at least a portion of the wrist to substantially preserve the length of the constraining tendons over the entire length of the wrist. The constraining tendon can passively constrain the motion of the articulated member without the use of an actuator, such as a force transmission mechanism and an algorithm to control it. For example, in various exemplary embodiments, motion of the disks of the articulated link structure may be passively constrained by restraining members that are not operable by an external drive or transmission mechanism. To achieve this, the passive restraining tendon is such that when an articulating member comprising the restraining tendon is bent in a pitch and/or yaw motion or the like, the restraining tendon is positive or negative in length between the first pair of adjacent disks. and to undergo a corresponding opposite negative or positive change between adjacent disks of the second pair that substantially cancels the change in length between adjacent disks of the first pair. may be extended accordingly. As a result, the length of the restraining tendon is substantially preserved. Also, because both ends of the restraining tendon are secured to both ends of the articulated member, which fixes the length of the restraining tendon, bending motion (eg, pitch and/or yaw motion) is such that the bending motion is substantially dependent on the restraining tendon. This is acceptable because it does not result in a change in the length of In contrast, translation does not result in conservation of the length of the restraining tendon, and since both fixed ends of the restraining tendon substantially prevent a change in the length of the restraining tendon, the wrist is moved transversely in an S-shape. The translational movement such as squeezing can be substantially prevented.

Referring to the exemplary embodiment of FIG. 5 , constraining tendons 332 and 336 are arranged such that the discs 315 and 314 are positioned in a direction 357 about axis 356 with constraining tendons 332 and 336 located therein. When rotated on one side of 310 towards each other, it undergoes a negative change in length. Restraining tendons 332 and 336 extend between disks 313 and 312 on the opposite side of wrist 310 where restraining tendons 332 and 336 extend between disks 315 and 314. It extends along a helical path throughout 310 . Thus, when disks 313 and 312 rotate in direction 353 about axis 352 in substantially the same manner as disks 315 and 314 , restraining tendons 332 and 336 engage disks 315 and 314 . ) undergo a positive change in length between disks 313 and 312 of a size that substantially cancels out a negative change in length between Likewise, wrist 310 is rotated in the opposite direction such that restraining tendons 332 and 336 undergo a positive change in length between disks 315 and 314 and negative change in length between disks 313 and 312 . When activated, the lengths of the restraining tendons 332 and 336 are still substantially conserved. Constraint tendons 330 and 334 also show that the change in length of restraining tendons 330 and 334 between disks 315 and 314 results in a change in length of restraining tendons 330 and 334 between disks 313 and 312. may extend along the helical path to substantially cancel out In addition, the constraining tendons 330 , 332 , 334 , and 336 cause a change in the length of the constraining tendons 330 , 332 , 334 , 336 between the discs 314 and 313 to cause the constraint between the discs 312 and 313 . The tendons 330 , 332 , 334 , 336 extend along the helical path to substantially counteract the change in length.

According to one exemplary embodiment, as shown in FIG. 3 , when the bending axes 350 , 352 , 354 , 356 of the wrist 310 are staggered in different (eg, orthogonal) directions, the restraining tendons 332 and 336 is, for example, from the position of the restraining tendons 332 and 336 in a position between the disks 315 and 314, such as position 370 shown in FIG. It may extend in a helical path over an angular range of approximately 180 degrees from a position between 312 to the position of restraining tendons 332 and 336 . In this way, restraining tendons 332 and 336 are positioned on opposite sides of the wrist 310 to facilitate preservation of the length of restraining tendons 332 and 336 . As discussed above, the restraining tendons 330, 332, 334, 336 are in a helical path over an angular range of approximately 90 degrees, from disk 311 to disk 312, from disk 312 to disk 313, and so on. It may extend, thus providing a helical path having an overall angular range from disk 311 to disk 313 of approximately 180 degrees. Similarly, restraining tendons 330 and 334 are the restraining tendons 330 and 334 at the position between the disks 313 and 312 from the position of the restraining tendons 330 and 334 at the position between the disks 315 and 314. It may extend along a helical path having an angular range of approximately 180 degrees to position. In addition, the restraining tendons 330 , 332 , 334 , and 336 can be moved from the position of the restraining tendons 330 , 332 , 334 , 336 in the position between the disks 313 and 314 to the position between the disks 312 and 311 . It may extend along a helical path having an angular range of approximately 180 degrees to the position of the restraining tendons 330 , 332 , 334 , 336 .

By securing restraint tendons 330 , 332 , 334 , 336 to both ends of wrist 310 , according to one exemplary embodiment, the bending angles of similar joints of the wrist will be substantially the same. By providing a wrist with substantially the same bending angle for similar joints, the movements of the wrist can be more easily controlled and smoother. According to one exemplary embodiment, when the wrist 310 is actuated such that the restraining tendons 332 , 336 between the discs 315 and 314 flex toward the side of the wrist 310 extending therefrom, the disc 315 and 314 rotate about axis 356 relative to each other and to substantially the same angle as disks 313 and 312 rotate about axis 352 relative to each other. This is because axes 356 and 352 are substantially parallel to each other. Likewise, when wrist 310 is actuated to cause rotation between disks 311 and 312 about axis 350 , disks 313 and 314 are also up to substantially the same angle about axis 354 . rotate

According to one exemplary embodiment, all of the restraining tendons of the wrist may extend in a co-circumferential helical path from the distal disk (eg, disk 311 ) to the proximal disk (eg, disk 315 ). However, in this exemplary embodiment, it may pass through one or more joint structures between adjacent disks of one or more of the constraining joints, which may result in weakening of the joint structure. To address this, the restraining tendons may be routed to extend along helical paths in different directions. For example, one restraining tendon may extend along a right-hand or left-handed twisted path along the proximal-distal direction of the instrument, and another restraining tendon may extend along the proximal-distal direction of the instrument and the other restraining tendon of the left or right hand It may extend along a twisted path of direction. As shown in the exemplary embodiment of FIG. 5 , the restraining tendon 330 extends along a helical path in a first direction 342 (eg, left-handed in the proximal-distal direction), the restraining tendon 334 . extends along a helical path from disk 311 to disk 315 in a second direction 344 different from the first direction 342 (eg, right-handed in the proximal-distal direction). For example, the first direction 342 and the second direction 344 are opposite to each other. By extending restraining tendons 330 and 334 along helical paths in respective directions 342 and 344 from disk 311 to disk 315, restraining tendons 330 and 334 are interposed between disks 311-315. Any joints 322 , 324 , 326 , 328 may extend without passing through.

Similarly, restraining tendons 332 and 336 physically route helical paths in opposite directions 342 and 344 from disk 311 to disk 315 such that they do not physically pass through any joints 322 , 324 , 326 , 328 , respectively. is extended according to According to one exemplary embodiment, at least a portion of both restraining tendons 330 and 336 extend along helical paths in direction 342 from disk 311 to disk 315 . According to one exemplary embodiment, at least a portion of both restraining tendons 334 and 332 extend along helical paths in direction 344 from disk 311 to disk 315 . That is, when wrist 310 includes four restraining tendons 330 , 332 , 334 , 336 , two of the restraining tendons spiral along direction 342 from disk 311 to disk 315 . may extend along a path, and the other two of the restraining tendons may extend along a helical path in direction 344 from disk 311 to disk 311 .

One consideration in constructing the restraining tendons is the movement of the wrist, the power required to actuate the wrist, and/or the friction force between the restraining tendons and the wrist components, which may affect the wear of the wrist components. is the size For example, in a wrist that uses a plurality of sets of actuation members to actively constrain the wrist, the actuation members generally extend along a straight path through the wrist and mechanism where bending occurs when the wrist is flexed. In wrists that use a plurality of sets of actuating members to constrain the wrist, the actuating members generally extend along a straight path through the wrist flex and bend generating mechanism wrists. Given the magnitude of the increased frictional force that may occur between the restraining tendons and wrist components due to, for example, the helical path of the restraining tendons as compared to a straight path, the restraining tendons may separate the helical paths in a manner that helps to minimize friction. may be extended accordingly.

Constraint tendons 330 , 332 , 334 , 336 rotate approximately 90 degrees as restraining tendons 330 , 332 , 334 , 336 traverse each pair of disks 311-315, according to one exemplary embodiment. Extending along helical paths with an angular range does not result in a significant increase in friction compared to conventional wrists that use multiple sets of straight tendons to constrain joint motion. This means that even though the restraining tendons 330, 332, 334, 336 extend along helical paths, the angle of wrap used to determine the magnitude of the friction force between the restraining tendons 330, 332, 334, 336 and the wrist components is This is because the winding angle of the straight tendons used to constrain the joint motion in the prior art list is not significantly greater. The frictional force between a tendon and its supporting surface can be expressed by the capstan equation T _load = T _hold e ^μΦ , where T _hold is the tensile force applied to the tendon (preload tensile force), and μ is is the coefficient of friction between the tendon and the support surface, Φ is the total angle swept by the twist of the tendon, and T _load is the force between the tendon and the support surface. Therefore, twisting the tendon through a large angle of Φ generates a large T _load force between the tendon and the supporting surface. In one exemplary embodiment, using a helical path with an angular range of approximately 90 degrees between each neighboring disk 311-315 is, for example, the three bending positions shown in the exemplary embodiment of FIG. 345, 346, 347 may be provided with a winding angle, for example having an angular range of approximately 40 degrees to approximately 70 degrees.

Exemplary embodiments of the various listings described herein may include disks arranged in various configurations. For example, the configuration shown in the exemplary embodiment of FIG. 3 may be referred to as an “ABAB” list due to the staggered orthogonal directions of axes 350 , 352 , 354 , 356 . In other exemplary embodiments, the wrist is such that instead of the axes of rotation between the disks staggered in orthogonal directions, two successive axes (eg, the axes of the intermediate disks) extend in substantially the same direction, the A construction following the "ABBA" form may be used, such that two successive axes are "bookend" by axes extending in the same direction and in a direction orthogonal to the two successive axes. there is.

The ABBA configuration works similarly to a constant velocity joint, which may be desirable when roll motion is transmitted through the wrist. For example, when a wrist is used in an instrument, and when roll motion is input to the instrument shaft, the roll motion is transmitted through the wrist, causing the distal end of the instrument, which may include an end effector, to roll likewise. Because the list includes one or more joints, the list acts like the input and output shafts of a vehicle drive train connected through the one or more joints. As is familiar to those skilled in the art, when an angle exists between the input and output shafts of a vehicle drive train, undesirable speed fluctuations occur between the input and output shafts. A wrist with an ABBA mechanism acts like a constant velocity joint similar to a double cardan joint with two A joints having substantially the same angle and two B joints having substantially the same angle, whereby the fluctuation of velocity between the input side and the output side It solves this problem by causing a substantial removal of Thus, the ABBA wrist can minimize or eliminate variations in velocity between the input and output sides of the wrist for roll motion applied to the instrument shaft.

Although the ABBA configuration may minimize or eliminate variations in velocity between the input and output sides of the list for roll motion, an ABAB configuration, such as the exemplary embodiment of FIG. While providing a minimum size per disk 311-315 compared to the ABBA configuration for the wrist 310 extending along these helical paths, it also substantially preserves the length of the restraining tendons 330 , 332 , 334 , 336 . and may be used to position the restraining tendons 330 , 332 , 334 , 336 such that the restraining tendons 330 , 332 , 334 , 336 do not pass through the joints connecting the disks. As a result, precise control of the motion of the wrist 310 can be obtained with smooth motion, and the joints connecting the disks 311-315 can be made small.

Although a wrist mechanism with an ABAB configuration essentially presents the disadvantage of providing a velocity variation between its input and output sides, it extends the restraining tendons along a helical path through at least a portion of the wrist and attaches the restraining tendons to both ends of the wrist. Fastening offers significant advantages that at least offset these disadvantages. Also, any speed fluctuations can be compensated for by control systems that adjust the input rotational speed to the wrist to achieve roll motion, such as by varying the input speed according to the bending angle of the wrist to compensate for the fluctuations in speed. .

Referring to FIG. 9 , one embodiment of an ABBA list using constraint tendons is shown. In Figure 9, wrist 600 includes disks 611-615 arranged in an ABBA joint configuration. In particular, joint 640 between disks 611 and 612 may enable rotation of disks 611 and 612 in direction 621 about axis 620 , and between disks 612 and 613 . A joint 642 of may enable rotation of the disks 612 and 613 in a direction 623 about an axis 622 , and a joint 644 between the disks 613 and 614 may ) may enable rotation of the disks 613 and 614 in a direction 625 about the rotation of the disks 614 and 615 of As shown in the exemplary embodiment of FIG. 9 , axes 620 and 626 may extend in substantially the same direction, and axes 622 and 624 may extend in substantially the same direction, and axis 620 may extend in substantially the same direction. , 626 may be substantially orthogonal to axes 622 and 624 , thereby creating an ABBA joint axis configuration (or any pitch-yaw-yaw-pitch rotation of disk pairs).

The wrist 600 also includes restraining tendons secured to both ends of the wrist 600 . List 600 includes four constraining tendons 630 , 632 , 634 , 636 , although other numbers of constraining tendons may be used, as shown in the exemplary embodiment of FIG. 9 . Unlike the exemplary embodiment of FIG. 3 in which the restraining tendons extend along a helical path having an angular range of approximately 90 degrees between each pair of discs, in the exemplary embodiment of FIG. Although 636 is substantially straight from disk 611 to disk 612 , from disk 612 to disk 613 , from disk 613 to disk 614 , and from disk 614 to disk 615 , , eg, along a twisted path across disk 613 to reach a point 180 degrees apart, or a spiral path having an angular range of approximately 180 degrees across disk 613 along another path. As a result, the lengths of the restraining tendons 630 , 632 , 634 , 636 can be preserved when the wrist 600 is articulated (eg, flexed). That is, instead of extending along a helical path having an angular range of approximately 90 degrees for all joints, the constraining tendons of the ABBA configuration cross a helical path having an angular range of approximately 180 degrees between Type B joints and A joints. It will extend along a spiral path having an angular range of approximately zero degrees.

This is further illustrated in FIG. 10 , which is a cross-sectional view along line 10-10 in FIG. 9 . As shown in FIG. 10 , each of restraining tendons 630 and 632 may span an angular range of approximately 180 degrees across disk 613 . Although lifted on disk 613 at different locations, restraining tendons 634 and 636 will have the same angular range as restraining tendons 630 and 632 . Since the restraining tendons 630 and 634 and the restraining tendons 632 and 636 intersect each other, respectively, the restraining tendons 630 and 634 and the restraining tendons 632 and 636 are at the same location in the cross-sectional view of the exemplary embodiment of FIG. is shown. Thus, the ABBA configuration can minimize velocity fluctuations between the input and output sides for roll motion, but allow the constraining tendons to pass through the center of the wrist. The wrist 600 may be configured such that the restraining tendons 630 , 632 , 634 , 636 are helically twisted along paths extending along the perimeter of the disk 613 , although this design would transverse the center of the disk 613 . It may be less practical than extending the paths across the

For example, when wrist 600 uses disks 500 and 540 of the exemplary embodiment of FIGS. 8A and 8B , restraining tendons will pass through a central lumen provided by central aperture 516 of the disks, thus It has the potential to interfere with any actuating member that might otherwise pass through the central lumen. Thus, if the central lumen would otherwise receive the actuating member for the end effector, the end effector actuating member would have to be routed through another lumen, which may require a different design when not positioned in the central lumen. . Also, because the angular range of the helical path of the constraining tendons 630, 632, 634, 636 is larger, the winding angle of the constraining tendons 630, 632, 634, 636 is also larger, which is compared with the list with the ABAB configuration. This may result in a larger amount of friction between the restraining tendons 630 , 632 , 634 , and 636 . The wrist 600 with the ABAB configuration may be used, for example, with relatively large diameter instruments subjected to relatively small loads. According to another exemplary embodiment, restraint tendons 630 , 632 , 634 , 636 may be configured to extend along paths that do not pass through the center of the central lumen. However, this embodiment will result in a larger winding angle of the restraining tendons 630 , 632 , 634 , 636 which will lead to increased friction between the restraining tendons 630 , 632 , 634 , 636 and the disk 613 . can

Although the exemplary embodiments of FIGS. 3 and 9 show lists comprising four joints, the articulating member of the list and other articulated link structures according to the exemplary embodiments described herein is provided at four joints. not limited For example, wrists and other articulated members may have two disks, three disks, five joints, six joints, eight joints, or a greater number of joints.

As described above with respect to the exemplary embodiments of Figures 3, 4, 9 and 10, a wrist-like jointed link structure comprises a series of connecting disks with tendons to provide a structure for constraining the movement of the wrist. may include However, other articulating members, whether used or not used as a list according to various exemplary embodiments of the present invention, may include other structures. Referring to FIG. 11 , one exemplary embodiment of an articulating member 700 is shown in which a braided structure 710 replaces a disc and forms the main body of the articulated member 700 . As in other exemplary embodiments described herein, the articulating member 700 may be a list of instruments, such as a surgical instrument, part of a parallel motion instrument, or other articulating component. 11 shows the articulating member 700 in a straight (ie, non-bending) state.

According to one exemplary embodiment, the braided structure 710 may have a hollow cylindrical or tubular shape defining a central passageway for the instrument component. FIG. 12 shows an enlarged view of a portion ( FIG. 12 ) of the braided structure of FIG. 11 . As shown, braided structure 710 may include plates 712 interweaved with each other. In the braided structure 710 , each of the plates 712 comprises a helical structure extending between the proximal end 702 and the distal end 704 of the articulated member 700 about the centerline of the braided structure 710 . and the centerline defines the helical axis. In one aspect (not shown), each of the plates 712 makes one revolution about the helical axis within the distance between the disks 721 and 722 .

11 and Enlarged Views It should be understood that FIG. 12 is a side view of an articulating member 700 including a braided structure 710 . 12 shows an enlarged view of a portion of the braided structure 710 and, more particularly, the geometrical relationship of the interwoven plate 712 . The warp 711 and weft 713 directions are intended to express the spiral angle of the plate 712 in two dimensions. The portion of braided structure 710 shown in FIG. 12 is a small, generally flat cross-section of plates 712 interwoven with each other. The warp 711 and weft 713 directions shown in FIG. 12 are an imaginary axis extending on the outer surface of the braided structure 710 along the length of the instrument (ie, substantially parallel to the centerline of the braided structure 710 ). Approximate angles of the plates with respect to a line formed by contacting one tangent plane with the outer curved surface of the braided structure 710 are shown. In one aspect, the angle between the warp 711 direction and the imaginary axis is equal to the angle between the weft 713 direction and the imaginary axis. In other words, the helix angle of the plate 712 aligned with the warp 711 direction is the same as the helix angle of the alignment plate 712 aligned with the weft thread 713 direction, and the two groups of plates have their helical-shaped hands It differs only in handedness (eg, one direction of plate 712 follows a right-handed helical direction, and another direction of plate 712 follows a left-handed helical direction). Such a plate configuration may result in a braided structure 710 having a bending stiffness that is substantially symmetrical with respect to a centerline of the braided structure 710 .

Each plate 712 may be formed by a plurality of filaments 714 extending along the warp yarn 711 or weft yarn 713 direction. The plate 712 may have a generally rectangular structure with a substantially flat surface that forms the outer surface 703 of the braided structure 710 as shown in FIGS. 11 and 12 . However, the plate may have other shapes, such as circular cross-sections, elliptical cross-sections or other shapes. Filaments 714 may be monofilaments, such as made of nylon or other flexible and strong material, and may have a diameter in the range of about 0.008 inches to about 0.012 inches, such as about 0.010 inches. The filament 714 is flexible such that the braid 714 can bend when the wrist including the filament 714 is actuated, but a compressive load will be applied to the filament 714 . It can be made of a material that allows it to have sufficient bending stiffness to minimize or prevent buckling when applied.

The braided structure 710 may be used to constrain the motion of the articulating member 700 as described herein by securing both ends of the braided structure 710 . Accordingly, the braided structure 710 may constrain the motion of the articulating member 700 instead of using constraining tendons to constrain the articulating member as in the exemplary embodiments of FIGS. 3 and 9 . According to one exemplary embodiment, the proximal end 702 of the braided structure 710 is secured to a disk 721 , which in turn moves the wrist 700 to the distal end of the surgical instrument shaft, in parallel motion. It may connect to other instrument components, such as the distal end of the instrument or other instrument structure (not shown). Similarly, the distal end 704 of the braided structure 710 is secured to a disk 722, which in turn connects the articulated member 700 with the distal end of an end effector (not shown) or other structure. It can be connected to the same other instrument components. The disks 721 , 722 differ from the disks of an articulating member, such as disks 311-315 of the wrist 300 of the exemplary embodiment of FIG. 3 in that they are not connected to each other via a joint or the like. Thus, the disks 721 , 722 may be connected to other instrument components, which may serve as both ends of the wrist, according to one exemplary embodiment.

The braided structure 710 may provide relatively smooth motion to the articulating member 700 when used, for example, as a wrist, and may be relatively inexpensive to manufacture. Also, similar to the wrist structure having an ABBA configuration, the braided structure 710 can minimize or eliminate velocity fluctuations between its input and output sides when exposed to rotational (roll) motion. The braided structure 710 is provided with a distal end 704 of the braided structure 710, such as a distal disk 722, to cause the braided structure 710 and thus the articulated member 700 to bend along an arc. eg a tensile or compressive force on an actuating member 730 that is connected to (eg, a pull-pull or push-pull actuation member that may be actuated in connection with a force transmission mechanism as described above with respect to the exemplary embodiment of FIG. 4 ). It can be operated by applying a force such as

According to another exemplary embodiment, the proximal end 702 and distal end 704 of the braided structure need not each be secured to disks, but instead can be secured directly to another instrument component without the use of disks. there is. Referring to FIG. 14 , there is shown a side view of a distal portion 750 of a surgical instrument comprising a wrist 751 including a braided structure 710 that forms a main body of the wrist 751 . The braided structure 710 may have the structure and features described in connection with the exemplary embodiment of FIG. 11 . The proximal end 702 of the braided structure 710 is secured directly to the distal end 754 of the surgical instrument component 572 , which may be, for example, a surgical instrument shaft, a distal end of a parallel motion instrument, or other instrument structure. Also, the distal end 704 of the braided structure 710 is secured directly to the proximal end 758 of an end effector 756 or other structure. The wrist 751 includes an actuation member 760 (eg, a pull-pull or push-pull actuation member) that is connected to the proximal end 758 of the end effector 756 to cause the wrist 751 to bend along an arc. An actuating member 760 may be included to articulate the wrist 751 by applying a force, such as a tensile force or a compressive force, to the wrist.

Articulating member 700 may include one or more structures for controlling the diameter of braided structure 710 such that the diameter of braided structure 710 does not substantially contract or enlarge under load, which would otherwise not be the case. In this case, the precision of the movement of the braided structure 710 may be affected. As shown in the exemplary embodiment of FIG. 11 , one or more disks 720 are positioned around the outer surface 708 of the braided structure 710 to control the outer diameter of the braided structure (ie, control the radial outer diameter). can be provided on Disk 720 is similar to disks 311-315 of list 310 of the exemplary embodiment of FIG. 3 in that disks 721 and 722 are not connected to each other or to disks 721 or 722 via joints or the like. It is different from a disc of the same articulating member. 11 , an actuating member 730 may extend through an aperture 723 in the disc 720 to guide the actuating member 730 to the distal disc 722 . The actuating member 730 may also extend through the apertures 725 of the disks 721 and 722 .

Although two disks 720 are shown to facilitate viewing of the braided structure 710 in the exemplary embodiment of FIG. 11 , for example, 1, 3, 4, 5, 6 or more Other numbers of disks 720 may be used, such as any number of disks. The braided structure 710 may also include an inner structure for controlling the inner diameter of the braided structure 710 . Referring to FIG. 13 , which shows a cross-sectional view of the articulated member 700 , an inner structure 740 may be provided within the braided structure 710 to control the inner diameter of the braided structure 710 . The inner structure 740 may have the shape of a hollow cylinder or tube having a central passage 742 , such as a spring or a hollow tube. The inner structure 740 is strong enough to resist radial deformation of the braided structure 710 , but also when the articulated member 700 and the braided structure 710 are actuated and flexed the inner structure 740 will It may be made of metal, plastic or other material that is flexible to be elastically deformed.

According to one exemplary embodiment, an articulating member comprising a braided structure may use a structure other than a disk, such as disk 720 of the exemplary embodiment of FIG. 11 , to control the diameter of the braided structure. 14 , wrist 751 may include a band 762 wrapped around braided structure 710 to control the diameter of braided structure 710 . Although two bands 762 are shown in the exemplary embodiment of FIG. 14 , other numbers of bands 762 are shown, such as, for example, 1, 3, 4, 5, 6, or more bands. may be used. Further, the band 762 may have no passageway for the actuation member 760 that extends beyond the band 762 between the proximal end 702 and the distal end 704 of the braided structure. Thus, as shown in the exemplary embodiment of FIG. 14 , wrist 751 having braided structure 710 includes a disk for securing proximal end 702 and distal end 704 of braided structure 710 and /or there may be no disk to control the diameter of the braided structure 710 .

According to one exemplary embodiment, braided structure 710 may extend along a helical path in direction 706 or direction 707 between proximal end 702 and distal end 704 . For example, individual filaments 714 may extend along helical paths. By providing a predetermined helical path to the braided structure 710 , the number of DOFs of the braided structure 710 can be controlled, thus the motion of the braided structure 710 and how the braided structure 710 moves into the wrist 700 . You can control whether to constrain the motion of For example, controlling the helical path traversed by the braided structure 710 can result in the degree of freedom allowed by the braided structure 710 depending on how the individual filaments are positioned relative to bending axes along the length of the braided structure 710 . can affect the number.

According to one exemplary embodiment, the braided structure 710 follows a helical path having an angular range of approximately 180 degrees between the proximal end 702 and the distal end 704 to provide zero degrees of freedom to the braided structure 710 . can be extended For example, filament 714 may extend along a helical path having an angular range of approximately 180 degrees between proximal end 702 and distal end 704 . The 180 degree angular range of the helical path results in the braided structure 710 in which the length of the filaments 714 is not preserved when the braided structure 710 is moved. Because both ends of the braided structure 710 are fixed and do not allow changes in length, bending and translation are substantially prevented, which would otherwise result in changes in the length of the braided structure 710 . A braided structure 710 with zero degrees of freedom will be resistant to bending like a wrist, but may be bent by a limited angle due to deformation of the filaments and/or plates under load.

According to another exemplary embodiment, the braided structure 710 is positioned approximately 360 degrees between the proximal end 702 and the distal end 704 to provide the braided structure 710 with two degrees of freedom, such as in any pitch and yaw direction. It may extend along a helical path having an angular range. For example, filament 714 may extend along a helical path having an angular range of approximately 360 degrees when traversing from proximal end 702 to distal end 704 . By extending along a helical path having an angular range of approximately 360 degrees, braided structure 710 is a series of ABAB configurations with two degrees of freedom, as bending motion in pitch and yaw directions may be allowed due to bending motion being length-conserving. It can function as a list containing the connected disks of On the other hand, since the translation is not length-conserving, and both fixed ends of the braided structure 710 will substantially prevent a change in the length of the braided structure 710, the braided structure 710 is S-shaped. Translation, such as moving, will be substantially prevented. On the other hand, since the braided structure 710 only has two degrees of freedom when extended along a spiral path having an angular range of approximately 360 degrees, the translation of the braided structure 710 in XY space can be constrained, such that the braid Structure 710 may articulate along an arc (eg, like a wrist), but one portion of braided structure 710 will not be able to translate transversely relative to another portion of braided structure 710 ( For example, described below in connection with the exemplary embodiment of FIG. 17 , and published May 17, 2011, US Pat. No. 7,942,868, and US, filed Jun. 13, 2007, US Patent Publication No. US 2008/0065105 as a parallel motion mechanism as described in patent application Ser. No. 11/762,165). Transverse translation of one portion of braided structure 710 with respect to another portion of braided structure 710 may be undesirable for lists that include braided structure 710 .

According to another exemplary embodiment, the braided structure 710 has an angular range of approximately 720 degrees between the proximal end 702 and the distal end 704 such that motion of the braided structure 710 is substantially unconstrained. It may extend along a helical path. For example, filament 714 may extend along a helical path having an angular range of approximately 720 degrees when traversing from proximal end 702 to distal end 704 . A braided structure extending in an angular range of approximately 720 degrees may be analogous to two successive braided structures extending along a helical path each having an angular range of approximately 360 degrees, providing one overall braided structure having a 4 DOF and (This would appear practically unconstrained to the user), allowing both bending and translational motion. As a result, not only can the braided structure 710 be bent in any pitch and yaw direction like a wrist, but also the braided structure 710 can be S-shaped as described below in connection with the exemplary embodiment of FIG. 17 . or as a parallel motion mechanism, such that the longitudinal axes through each of the proximal end 702 and the distal end 704 are offset from each other but still substantially parallel to each other.

When braided structure 710 is used in articable member 700 , braided structure 710 may be used to replace a series of disks connected at joints as shown in the exemplary embodiment of FIG. 11 . That is, the braided structure 710 itself may provide the structure and body of the articulated member 700 from one end to the other. In one such exemplary embodiment, the articulating member 700 may be used as a wrist, and may have the same diameters as the wrist structures discussed in the above exemplary embodiments. Further, the braided structure 710 may have both torsional and compressive stiffness, and may be positioned under tension and compression.

Although braided structure 710 may be used to replace connected disks and provide restraining motion to the wrist, such as in the exemplary embodiment of FIG. For example, it may be used with connected disks to provide a list). In this case, the braided structure may replace restraining tendons, such as restraining tendons 330 , 332 , 334 , 336 of the exemplary embodiment of FIG. 3 . Referring to FIG. 15 , there is shown a side view of an articulate member 800 including connected disks 801-805 and a braided structure 810 . Disks 801-805 may be connected and configured in the same manner as the exemplary embodiment of FIG. 3 (ie, in an ABAB configuration). To constrain the motion of the disks 801-805, such as to allow controlled bending along an arc, the braided structure 810 is external to the disks 801-805, as shown in the exemplary embodiment of FIG. It can be provided around. Braided structure 810 may be constructed according to the exemplary embodiment of FIG. 11 , with filaments 714 forming plate 712 interwoven to form a full hollow cylindrical or tubular structure around disks 801-805. ) may be included. A proximal end 812 and a distal end 814 of the braided structure 810 may be secured relative to the disks 801-805. According to one exemplary embodiment, the proximal end 812 and the distal end 814 of the braided structure 810 can be secured to place the braided structure 810 under tension, and the disks 801-805 are subjected to a compressive load. support the Also, according to one exemplary embodiment, by disposing the braided structure 810 around the outside of the disks 801-805, the inner diameter of the braided structure 810 can be controlled by the disks 801-805 itself. there is.

As discussed in the exemplary embodiment of Figures 3-15, the articulating member with constraining motion may be a wrist. However, the articulating member having constraining motion is not limited to the list. According to one exemplary embodiment, an articuable member having constraining motion is disclosed such that its function is, for example, published May 17, 2011, US Pat. It may be a parallel exercise device described in US Patent Publication No. US 2008/0065105.

Referring to FIG. 16 , there is shown a distal portion 900 of a surgical instrument comprising a parallel motion instrument 910 coupled to an instrument shaft 906 . The instrument may be a camera instrument or a surgical instrument having an end effector 908 according to the exemplary embodiment of FIG. 2 . Although the instrument may not have a wrist 902 , according to one exemplary embodiment, the instrument distal portion 900 includes a wrist 902 that can be constructed, for example, according to any of the exemplary embodiments described above. may include

As shown in the exemplary embodiment of FIG. 16 , parallel motion instrument 910 may include a straight shaft section 916 that separates proximal joint instrument 912 from distal joint instrument 914 . Similar to the exemplary embodiments of US Patent No. 7,942,868, published May 17, 2011, and US Patent Publication No. US 2008/0065105, published March 13, 2008, joint mechanisms 912 and 914 and straight sections 916 ) are connected together to work cooperatively with each other. According to one exemplary embodiment, the proximal joint instrument 912 and the distal joint instrument 914 may include a plurality of connected disks similar to a wrist. The disk may include, for example, mechanical stops (not shown) to limit motion of the joint mechanisms 912 , 914 , for example in pitch and/or yaw directions.

20 shows an end view of one exemplary embodiment of a disk 1100 of a joint mechanism for a parallel exercise mechanism. The disk 1100 may include a central hole 1102 , a connecting portion 1104 , and holes for a plurality of actuating members. For example, disk 1100 may include a plurality of apertures 1110 for wrist drive tendons, a plurality of apertures 1120 for parallel motion mechanism drive tendons, and a plurality of apertures for constraining tendons, as further described below. 1130) may be included. As shown in the exemplary embodiment of FIG. 20 , the holes 1110 , 1120 , 1130 are disposed at the same distance (eg, radius) relative to the center of the disk 1100 (eg, the center of the central hole 1102 ). Alternatively, the holes 1110 , 1120 , 1130 may be disposed at different distances (eg, radii) relative to the center of the disk 1100 .

FIG. 17 shows the exemplary embodiment of FIG. 16 in which the parallel motion mechanism 910 has been actuated. As shown in FIG. 16 , the parallel motion device 910 may control the relative orientation of the proximal end portion 915 of the parallel motion device 910 and the distal end portion 917 of the parallel motion device 910 . . As a result, the longitudinal axis 913 through the distal end portion 917 of the parallel motion instrument 910 is substantially to the longitudinal axis 911 through the proximal end portion 915 of the parallel motion instrument 910 . may be parallel (longitudinal axis 911 may also be a longitudinal axis of instrument shaft 906 not shown in FIG. 16 ). Thus, the position of the end effector 908 , a camera device (not shown), or other components located at the distal end 904 of the instrument distal portion 900 may change in XY space, but Orientation with respect to longitudinal axis 911 may be maintained (before any motion due to wrist 902 is addressed).

Unlike motion of a wrist, which may be constrained to substantially follow an arc, motion of parallel motion instrument 910 translates parallel motion device 910 in XY space as shown in the exemplary embodiment of FIG. 16 . may be constrained to do so. Motion along the arc through the proximal joint 912 to the distal joint 914 does not translate the distal end portion 917 of the parallel motion instrument 910 in XY space while the proximal of the distal end portion 917 is By maintaining orientation relative to end 915 , motion of parallel motion mechanism 910 can be constrained such that motion along the arc is minimized or prevented. As a result, the parallel motion mechanism 910 may be constrained in a manner substantially opposite to the listings of the exemplary embodiments of FIGS. 3-15 . That is, wrists allow bending motion but can be constrained to minimize or prevent translation in XY space which could result in an sigmoid, etc., whereas parallel motion mechanisms allow translation in XY space but not arc. may be constrained to minimize or prevent subsequent bending motion.

Referring to FIG. 18 , the exemplary embodiment of FIG. 16 is shown with the shaft 906 and the outer surface of the straight section 916 of the parallel motion mechanism 910 raised to expose the internal components. As shown in the exemplary embodiment of FIG. 18 , the straight section 916 can include a central tube 918 extending between a proximal joint instrument 912 and a distal joint instrument 914 . The center tube 918 may be hollow, allowing components of the instrument to pass through the interior of the center tube 918 to, for example, the wrist 902 and/or the end effector 908 .

As shown in the exemplary embodiment of FIG. 18 , a wrist drive tendon 920 may extend from a shaft 906 through a parallel motion mechanism 910 to a wrist 902 , wherein the wrist drive tendon 920 may , may be attached to the distal end of the wrist 902 or the distal end 904 of the instrument distal portion 900 to actuate the wrist 902 , as described above with respect to the exemplary embodiment of FIG. 3 . As shown in the exemplary embodiment of FIG. 18 , a drive tendon 920 may extend over an outer surface of the center tube 918 . According to one exemplary embodiment, wrist drive tendon 920 passes through an annular space provided between center tube 918 and outer casing 919 (shown in FIGS. 16 and 17 ) of straight section 916 . can do.

The instrument also includes one or more tendons for actuating the parallel motion instrument 910 . For example, a parallel movement mechanism actuation member 930 may extend from the shaft 906 through the parallel movement mechanism 910 and be secured to the distal end 914 of the parallel movement mechanism 910 , 910 may be actuated, such as by applying a force to tendon 930 . According to one exemplary embodiment, the actuating member 930 may be a pull-pull actuating member or a push-pull actuating member. Some parallel exercise devices may use three actuation tendons to actuate the parallel exercise device due to restrictions on the size of the interior space within the parallel exercise device. However, the parallel motion mechanisms of the exemplary embodiments described herein may provide for an increase in interior space due to their configuration, allowing a variable number of drive tendons to be used. For example, four actuating members 930 arranged in pairs in which actuation member 930 is connected to a capstan, eg similar to actuation member 364 of the exemplary embodiment of FIG. 4 , actuates parallel motion mechanism 910 . , which provides a robust structure and control for the actuating actuation tendon and parallel motion mechanism 910 . The actuating member 930 may extend above the center tube 918 . According to one exemplary embodiment, the actuating member 930 may pass through an annular space provided between the central tube 918 and the outer casing 919 of the straight section 916 .

The parallel motion mechanism 910 may also include one or more restraining members secured to both ends of the parallel motion mechanism 910 according to one exemplary embodiment. For example, restraint tendon 940 may extend from distal end 915 to proximal end 917 of parallel motion instrument 910 , restraining tendon 940 having distal end 915 and proximal end 917 . ) is fixed to Restraint tendon 940 may be placed in place, for example, through welding restraint tendon 940 to a component of parallel motion mechanism 910, crimping restraint tendon 940 to another object, or by other techniques familiar to those skilled in the art. can be fixed to In the exemplary embodiment of FIG. 18 , the distal ends of the restraining tendon 940 are secured to the disk of the distal joint instrument 914 and secured to the disk of the proximal joint instrument 912 . As shown in the exemplary embodiment of FIG. 18 , one end of the restraining tendon may be secured to the distal end 917 of the parallel motion instrument 910 by a distal crimp 941 , Another end may be secured to the proximal end 915 of the parallel motion instrument 910 by a proximal crimp 943 . As shown in the exemplary embodiment of FIG. 18 , a restraining tendon 940 may extend over the outer surface of the central tube 918 . According to one exemplary embodiment, the restraining tendon 940 may pass through an annular space provided between the central tube 918 and the outer casing 919 (shown in FIGS. 16 and 17 ) of the straight section 916 . can

The parallel motion mechanism of the exemplary embodiments described herein provides similar motion and Although functional, the parallel motion mechanism of the exemplary embodiments described herein advantageously provides smooth and precise motion of the parallel motion mechanism along with a greater interior space for more components, such as drive and/or restraint tendons. It may have other structures that

According to one exemplary embodiment, the parallel movement mechanism 910 does not include the reinforcing bracket 1670 described in US Pat. No. 7,942,868, resulting in a greater interior space within the parallel movement mechanism 910 . Although the reinforcing bracket 1670 described in US Pat. No. 7,942,868 occupies some interior space, the configuration of the reinforcing bracket 1670 is such that both the restraining cables and the actuating cables extend straight through the parallel motion mechanism. , increased the tensile force applied to the actuation cable 1680 connected to the bracket 1670 . To address this, the actuating member 930 of the parallel motion mechanism 910 may extend along a helical path along at least a portion of the parallel motion mechanism 910 . This is further in the exemplary embodiment of FIG. 19 showing a center tube 1018 of a parallel exercise device having a wrist drive tendon 1020 , a restraining tendon 1040 and a parallel motion mechanism drive tendon 1032 , 1034 , 1036 , 1038 . shown in detail. As shown in FIG. 19 , wrist drive tendon 1020 and restraint tendon 1040 may be substantially straight, while parallel exercise instrument drive tendons 1032 , 1034 , 1036 , 1038 circumscribe center tube 1018 . extends in a spiral path. According to one exemplary embodiment, parallel motion instrument drive tendons 1032 , 1034 , 1036 , 1038 extend along a helical path having an angular range of approximately 180 degrees along center tube 1018 as shown in FIG. 19 . can be For example, parallel exercise instrument tendon 930 of FIG. 18 including parallel exercise instrument drive tendon 934 can be connected from proximal end 915 of parallel exercise instrument 910 to distal end 917 of parallel exercise instrument 910 . ) may extend along a helical path having an angular range of approximately 180 degrees.

Because the parallel motion mechanism actuation member may extend along a helical path along at least a portion of the parallel motion mechanism, mechanical advantages may be provided to the tendons without the use of reinforcing brackets and mechanisms employed in other parallel mechanism designs. For example, when the parallel exercise instrument 910 is actuated as shown in FIG. 17 , the parallel exercise instrument drive tendon 934 is at the bottom side 950 of the parallel exercise instrument 910 at the proximal end 915 . position, causing a positive change in the length of the actuation tendon 934 and causing an additional tensile force to be applied to the actuation tendon 934 . However, because the same drive tendon 934 extends along a helical path having an angular range of approximately 180 degrees, the drive tendon 934 at the distal end 917 is on the upper side 954 of the parallel motion instrument 910 . positioned so that the drive tendon 934 also undergoes a change in the amount of length at the distal end 917 that tensions the drive tendon 934 . Thus, actuation member 930 including tendon 934 can extend along a helical path along parallel motion mechanism 910 , providing a mechanical advantage for actuating parallel motion mechanism 910 , while at the same time providing other mechanical advantages. Eliminating the internal structural support elements also creates a larger interior space for the components.

18 , in contrast to actuation member 930 , restraint tendon 940 follows a substantially straight path as it extends through parallel motion mechanism 910 . As a result, when the parallel motion instrument 910 is actuated as shown in FIG. 17 , the restraining tendon 940 on the bottom side 950 of the proximal joint instrument 912 undergoes a positive change in length. Because the restraining tendons 940 are secured to both ends of the paralleling mechanism 910 , the same restraining tendons 940 extending along the bottom side of the paralleling mechanism 910 are at the bottom of the distal joint mechanism 914 . The side 952 undergoes a negative change in length such that the distal joint instrument 914 and the proximal joint instrument 912 are offset but parallel to the distal end 917 and the proximal end 915 of the parallel motion instrument 910 . Make it counter-bend to provide positioning.

As illustrated in the exemplary embodiments of FIGS. 16-20 , a parallel exercise device may use tendons as a mechanism to constrain the motion of the parallel exercise device. In other exemplary embodiments, the parallel exercise mechanism may include a braided structure as described in the exemplary embodiments of FIGS. 11-15 . According to one exemplary embodiment, a braided structure may replace the disks of the proximal joint instrument 912 and the distal joint instrument 914 of the parallel motion instrument 910 in the manner described with respect to the exemplary embodiment of FIG. 11 . can In another exemplary embodiment, a braided structure may be disposed around the disks of the proximal joint instrument 912 and the distal joint instrument 914 as described in connection with the exemplary embodiment of FIG. 15 .

Although a wrist and parallel exercise device according to the exemplary embodiments described herein may be used independently (ie, an instrument may include a wrist or parallel exercise device), an instrument may include both wrist and parallel exercise devices. may be When the device includes both a wrist and a parallel motion device, the wrist may include a constraining mechanism, such as a constraining tendon, separate from the constraining mechanism, such as a constraining tendon of the parallel motion device. For example, the wrist includes a first restraint mechanism, such as a first set of one or more restraining tendons, and the parallel motion mechanism includes a second restraint mechanism, such as a second set of one or more restraining tendons. According to one exemplary embodiment, when the wrist and parallel exercise device have separate constraining tendons, the constraining tendons of the wrist and parallel exercise device may, for example, be of different diameters or other structural or may be different by having material differences and the like.

According to another embodiment, the wrist and parallel motion mechanism use the same restraint mechanism, such as the same restraint tendon. Using the same restraint mechanism for the wrist and parallel movement mechanism may be effective in saving internal space in an apparatus using the same restraint mechanism for both the wrist and parallel movement apparatus.

Referring to FIG. 21 , there is shown a partial view of a distal end portion 1200 of an instrument including a wrist 1202 and parallel motion instrument 1204 that may be constructed in accordance with the exemplary embodiments of FIGS. 16-20 . there is. The wrist 1202 may be constructed according to the exemplary embodiments of FIGS. 3-14 , and the parallel exercise device 1204 may be constructed according to the exemplary embodiments of FIGS. 15-19 . 21 , wrist 1202 may be disposed on the distal side of parallel exercise device 1204 . The wrist driven tendon 1220 is a wrist driven tendon 1220 to actuate the distal end of the wrist 1202 or the wrist 1202 via the parallel exercise mechanism 1204 to and through the wrist 1202. It may extend to the distal end 1203 of the instrument being secured. Parallel exercise instrument drive tendon 1230 may extend through parallel exercise instrument 1204 and be secured to a distal end of parallel exercise instrument 1204 .

According to one illustrative embodiment, wrist 1202 and parallel exercise device 1202 share a restraining tendon that constrains motion of both wrist 1202 and parallel exercise device 1204 . For example, restraint tendons for both wrist 1202 and parallel exercise instrument 1204 extend through and are secured (eg, at the distal end of parallel exercise instrument 1204 , wrist 1202 ). ) at the proximal end of or via a crimp 1210 or the like described below between the parallel motion instrument 1204 and the wrist 1202), and comprising a first portion 1240A of a restraining tendon (via the wrist 1202) It extends and carries a second portion 1240B of the restraining tendon which is also fixed. The first and second portions 1240A, 1240B are comprised of the same continuous restraining tendons such that the same restraining tendons (portions 1240A and 1240B) are used to restrain both wrist 1202 and parallel motion mechanism 1204 . can be used For example, the restraining tendon may be at the distal end of the parallel exercise instrument 1204, at the proximal end of the wrist 1202, or at the wrist 1202 and parallel exercise instrument 1204, as shown in the exemplary embodiment of FIG. It can be fixed to the connection area 1205 between. Accordingly, a set of restraint tendons (including portions 1240A and 1240B) may be used to restrain movement of both wrist 1202 and parallel exercise instrument 1204, which results in efficient use of the instrument's interior space. provides

According to one exemplary embodiment, wrist 1202 and parallel exercise device 1204 have separate restraining tendons that constrain motion of wrist 1202 and parallel exercise device 1204, respectively. For example, the first portion 1240A of restraining tendons represents a first set of one or more restraining tendons, and the second portion 1240B of restraining tendons is a second set separate from the first portion 1240A of restraining tendons. represents one or more restraining tendons of When wrist 1202 and parallel exercise device 1204 are different restraining tendons, the restraining tendon for parallel exercise instrument 1204 (eg, first portion 1240A) is, for example, at the distal end of parallel exercise instrument 1204 . For example, a restraining tendon (eg, second portion 1240B) for wrist 1202 may be secured at the proximal end of wrist 1202 or between parallel exercise device 1204 and wrist 1202 , for example secured to the distal end of the parallel exercise instrument 1204 , at the proximal end of the wrist 1202 , or between the parallel exercise instrument 1204 and the wrist 1202 , and extending through the wrist 1202 , may be secured to the distal end.

The restraining tendon may be secured in accordance with the exemplary embodiments of FIGS. 3-20 . For example, a first portion 1240A of a restraint tendon extends through a parallel motion instrument 1204 and ends at a crimp 1210 securing the restraint tendon 1240 against an instrument distal end 1200 . , the second portion 1240B of the restraining tendon separately passes through the wrist 1202 (such as when separate restraining tendons control the wrist 1202 and parallel motion mechanism 1204 ), or the restraining tendon is crimped From 1210 it can be continued as a second portion 1240B of the same restraining tendon passing through both the parallel exercise mechanism 1204 and wrist 1202 . Further, restraint tendons may also extend substantially linearly through parallel motion mechanism 1204 and wrist 1202, eg, restraint tendons (eg, portions 1240A, 1240B), in accordance with the exemplary embodiments of FIGS. 3-20 . ) through at least a portion of the helical path.

Exemplary embodiments and methods described herein have been described for use with surgical instruments for teleoperated surgical systems. However, the exemplary embodiments and methods described herein are compatible with other surgical devices, such as laparoscopic surgical instruments and other manual (eg, handheld) instruments, and wrist and/or parallel motion instruments that are teleoperated, telecontrolled or manually operated. It may also be used with non-surgical devices, such as devices comprising a variety of actuated articulate members, including but not limited to:

By providing a surgical instrument having restraint mechanisms in accordance with exemplary embodiments described herein, an articulate member is provided having a simpler force transmission mechanism that is easier to control and less expensive to manufacture, while at the same time providing an articulate member. provides a substantially repeatable, smooth and precise movement.

Still other modifications and variations of embodiments may become apparent in light of what has been described herein. For example, the systems and methods may include additional components or steps that are omitted from the drawings and description for clarity of operation. Accordingly, the description herein is to be construed as illustrative only and for the purpose of teaching those skilled in the art in the general manner of carrying out the present invention. It should be understood that the various embodiments shown and described herein are to be treated as examples. Various elements and materials and the construction of such various elements and materials may be substituted for those shown and described herein, and the order of parts and processes may be reversed, as would be apparent to one of ordinary skill in the art having the advantages described herein. and any specific feature of the taught embodiments may be used independently. Changes may be made in the elements described herein without departing from the spirit and scope of the specification and claims.

It is to be understood that the specific examples and embodiments described herein are not intended to be limiting, and that changes in structure, dimensions, materials, and methods may be made without departing from the scope of the present specification.

Other embodiments in accordance with the present invention will become apparent to those skilled in the art from consideration of the detailed description and examples of the invention set forth herein. The detailed description and examples are to be regarded as illustrative only, and the true spirit and scope of the invention is to be defined by the appended claims.

Claims (31)

Absence of joint movement,
a plurality of links extending in series from the proximal end link to the distal end link, wherein adjacent links of the plurality of links are pivotally coupled to form a joint therebetween;
an actuating member extending from the proximal end link to the distal end link, operatively coupled to the plurality of links to transmit a force to flex the articulated member from a neutral position; and
a constraining member extending from the proximal end link to the distal end link, the constraining member having opposite ends each secured to the distal end link and the proximal end link;
the constraining member extends through a through hole in each link of the plurality of links, the through hole being radially offset from a central axis of the link;
wherein the restraining member follows a helical path along at least a portion of the articulated member from the proximal end link to the distal end link;
In the straight form of the articulation member, the constraining member is under a tension force between the ends. The articulating member of claim 1 , wherein the articulating member is a wrist. 3. The articulating member of claim 2, wherein the constraining member passively constrains translation of the links. 3. The articulating member of claim 2, wherein the actuating member extends substantially linearly along the articulating member from the distal end link to the proximal end link. 3. The articulating member according to claim 2, wherein the axes of rotation of successive ones of the joints between the adjacent links are oriented to be orthogonal to each other. 6. The articulating member of claim 5, wherein an angular range of a helical path of the constraining member between adjacent ones of the plurality of links is 90 degrees. 6. The articulating member of claim 5, wherein the constraining member comprises a plurality of constraining members, wherein the helical path of the first constraining member is right-handed and the helical path of the second constraining member is left-handed. 3. The method of claim 2,
The joint between the adjacent links includes two continuous joints and two neighboring joints, wherein a first neighboring joint of the two neighboring joints is disposed next to a first continuous joint of the two consecutive joints, a second neighboring joint of the neighboring joints is disposed next to a second continuous joint of the two continuous joints,
each of said two successive joints has an axis of rotation extending in substantially the same direction;
wherein each of the neighboring joints has an axis of rotation extending in a direction substantially orthogonal to the axis of rotation of the two successive joints. 9. The articulating member according to claim 8, wherein the angular range of the helical path of the constraining member between the two successive joints is 180 degrees. The articable member of claim 1 , wherein the constraining member is part of a braided structure. 11. The articulating member of claim 10, wherein the angular range of the braided structure between the distal and proximal ends of the braided structure is 180 degrees. 11. The articulating member of claim 10, wherein the angular range of the braided structure between the distal and proximal ends of the braided structure is 360 degrees. 11. The articulating member of claim 10, wherein the angular range of the braided structure between the distal and proximal ends of the braided structure is 720 degrees. 11. The articulating member of claim 10, further comprising a member disposed within the braided structure and a member disposed outside of the braided structure to limit expansion and contraction of the braided structure. 11. The articulating member of claim 10, wherein the braided structure forms a body structure of the articulated member from the proximal end link to the distal end link. 11. The articulating member of claim 10, wherein the braided structure constrains motion of the plurality of links. The articulating member of claim 1 , wherein the articulating member is a list of surgical instruments. The method of claim 1,
Further comprising a plurality of actuating members and a plurality of constraining members,
the actuating member is one of the plurality of actuating members;
wherein the constraining member is one of the plurality of constraining members. delete delete delete delete delete a surgical instrument,
shaft;
a force transmission mechanism connected to the proximal end of the shaft;
a parallel motion mechanism connected to the distal end of the shaft;
a wrist comprising a plurality of links and connected to the distal end of the parallel exercise device;
an actuation member operatively coupled to transmit a force from the force transmission mechanism to flex the wrist from a neutral position; and
a constraining member extending through the wrist and parallel motion mechanism, the constraining member being arranged to passively constrain motion of the wrist mechanism and the parallel motion mechanism;
both ends of the restraining member are respectively secured to the distal end of the wrist and the proximal end of the parallel motion instrument;
A portion between both ends of the restraining member is fixed to a portion of the surgical instrument between the wrist and the parallel motion instrument,
wherein the restraining member follows a substantially linear path along the parallel motion instrument and a helical path along at least a portion of the wrist. delete 25. The surgical instrument of claim 24, further comprising an end effector coupled to the distal end of the wrist. 25. The method of claim 24,
the actuation member is operatively coupled to the force transmission mechanism and the wrist to transmit a force from the force transmission mechanism to flex the wrist;
wherein the wrist actuating member extends in a substantially straight path along the parallel movement instrument and the wrist. 25. The method of claim 24,
the actuating member is operatively coupled to the force transmission mechanism and the parallel movement mechanism to transmit a force from the force transmission mechanism to flex the parallel movement mechanism;
wherein the parallel motion instrument actuating member follows a helical path along at least a portion of the parallel motion instrument. delete delete delete

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